Healthcare Provider Details

I. General information

NPI: 1508805532
Provider Name (Legal Business Name): ERIC CHARLES DUPREE M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

Provider Other Name: ERIC CHARLES DUPREE M.D.

II. Dates (important events)

Enumeration Date: 06/05/2006
Last Update Date: 02/14/2025
Certification Date: 02/14/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1102 N PINE RD
OLLA LA
71465-4804
US

IV. Provider business mailing address

1102 N PINE RD
OLLA LA
71465-4804
US

V. Phone/Fax

Practice location:
  • Phone: 318-495-3131
  • Fax: 318-495-0749
Mailing address:
  • Phone: 318-495-3131
  • Fax: 318-495-0749

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License NumberMD.024984
License Number StateLA
# 2
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberL024984
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: