Healthcare Provider Details

I. General information

NPI: 1053468512
Provider Name (Legal Business Name): DARREN J. DUET MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/05/2007
Last Update Date: 01/12/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

753 INDUSTRIAL PARK RD
LAROSE LA
70373-5967
US

IV. Provider business mailing address

753 INDUSTRIAL PARK RD
LAROSE LA
70373-5967
US

V. Phone/Fax

Practice location:
  • Phone: 985-601-4839
  • Fax: 985-693-1439
Mailing address:
  • Phone: 985-601-4839
  • Fax: 985-693-1439

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number024785
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: