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General NPI Number Information
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NPI Number | 1487946208
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Entity Type | Individual
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Provider Name | FREDERICK E DUBOIS REGPH
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Gender | Male
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Dates
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Enumeration Date | 05/12/2011
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Last Update Date | 05/12/2011
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Provider Practice Location Address
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Address Line | 1150 W SAINT PETER ST
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City | NEW IBERIA
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State | LA
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Zip | 70560-3558
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Country | US
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Telephone | 337-367-9347
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Fax |
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Provider Business Mailing Address
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Address Line | 106 AZALEA DR
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City | ABBEVILLE
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State | LA
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Zip | 70510-5612
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Country | US
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Telephone | 337-893-8790
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Fax |
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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 | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 9240
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License Number State | LA
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