Healthcare Provider Details

I. General information

NPI: 1811061831
Provider Name (Legal Business Name): NOEL M DUPLANTIER MD FAC OG
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/20/2006
Last Update Date: 12/15/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1009 BENIGNO LANE
BAY SAINT LOUIS MS
39520
US

IV. Provider business mailing address

PO BOX 2778
BAY SAINT LOUIS MS
39520
US

V. Phone/Fax

Practice location:
  • Phone: 228-467-2555
  • Fax: 228-467-5480
Mailing address:
  • Phone: 228-467-2555
  • Fax: 228-467-5480

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number17207
License Number StateMS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: