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General NPI Number Information
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NPI Number | 1801966833
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Entity Type | Individual
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Provider Name | JOSE D QUITAIN III M.D.
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Gender | Male
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Dates
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Enumeration Date | 11/08/2006
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Last Update Date | 04/09/2008
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Provider Practice Location Address
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Address Line | 211 4TH ST BOX 30101
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City | ALEXANDRIA
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State | LA
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Zip | 71301-8421
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Country | US
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Telephone | 318-449-7383
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Fax |
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Provider Business Mailing Address
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Address Line | 211 4TH ST BOX 30101
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City | ALEXANDRIA
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State | LA
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Zip | 71301-8421
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Country | US
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Telephone | 318-449-7383
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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 | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | 201160
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License Number State | LA
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