Healthcare Provider Details

I. General information

NPI: 1013917467
Provider Name (Legal Business Name): WHITNEY JAMES DUHON III PHYSICAL THERAPIST
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/28/2005
Last Update Date: 02/11/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

119 ARNOULD BLVD
LAFAYETTE LA
70506-6213
US

IV. Provider business mailing address

119 ARNOULD BLVD
LAFAYETTE LA
70506-6213
US

V. Phone/Fax

Practice location:
  • Phone: 337-769-1281
  • Fax: 337-769-1283
Mailing address:
  • Phone: 337-769-1281
  • Fax: 337-769-1283

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPT04788
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: