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General NPI Number Information
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NPI Number | 1194139048
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Entity Type | Individual
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Provider Name | KETERAL JAMES DUCOTE II NP-C
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Gender | Male
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Dates
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Enumeration Date | 06/18/2014
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Last Update Date | 08/19/2025
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Provider Practice Location Address
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Address Line | 5416 HIGHWAY 28 E
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City | PINEVILLE
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State | LA
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Zip | 71360-4756
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Country | US
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Telephone | 318-216-1010
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Fax | 318-302-0504
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Provider Business Mailing Address
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Address Line | 919 HIDDEN RDG
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City | IRVING
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State | TX
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Zip | 75038-3813
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Country | US
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Telephone | 469-282-2711
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Fax | 469-282-2609
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | AP07864
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License Number State | LA
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