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General NPI Number Information
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NPI Number | 1043222649
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Entity Type | Individual
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Provider Name | JOHN R DUPRE MD
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Gender | Male
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Dates
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Enumeration Date | 08/12/2006
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Last Update Date | 06/30/2015
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Provider Practice Location Address
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Address Line | 604A S 8TH ST
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City | GRIFFIN
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State | GA
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Zip | 30224-4214
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Country | US
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Telephone | 770-227-1999
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Fax |
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Provider Business Mailing Address
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Address Line | 604A S 8TH ST
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City | GRIFFIN
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State | GA
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Zip | 30224-4214
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Country | US
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Telephone | 770-227-1999
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Fax | 770-233-0998
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RP1001X
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Taxonomy Name | Pulmonary Disease Physician
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License Number | 031590
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License Number State | GA
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Taxonomy #2
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 031590
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License Number State | GA
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