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General NPI Number Information
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NPI Number | 1558240291
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Entity Type | Individual
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Provider Name | JUSTIN BLAKE DUMAS
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Gender | Male
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Dates
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Enumeration Date | 08/28/2025
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Last Update Date | 08/28/2025
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Provider Practice Location Address
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Address Line | 19065 DR JOHN LAMBERT DR STE 1600
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City | HAMMOND
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State | LA
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Zip | 70403-1038
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Country | US
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Telephone | 985-590-4953
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Fax |
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Provider Business Mailing Address
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Address Line | 137 OAKMONT DR
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City | LA PLACE
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State | LA
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Zip | 70068-1727
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Country | US
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Telephone | 504-239-2614
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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 | 374700000X
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Taxonomy Name | Technician
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License Number |
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License Number State |
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