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General NPI Number Information
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NPI Number | 1952461204
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Entity Type | Individual
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Provider Name | KEITH J LUPER DPM
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Gender | Male
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Dates
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Enumeration Date | 12/09/2006
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Last Update Date | 02/23/2010
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Provider Practice Location Address
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Address Line | 2750 EAST GAUSE BLVD.
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City | SLIDELL
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State | LA
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Zip | 70461
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Country | US
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Telephone | 985-639-3777
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Fax |
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Provider Business Mailing Address
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Address Line | 1514 JEFFERSON HIGHWAY
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City | NEW ORLEANS
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State | LA
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Zip | 70121
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Country | US
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Telephone | 504-842-4000
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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 | 213E00000X
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Taxonomy Name | Podiatrist
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License Number | 266
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License Number State | AL
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Taxonomy #2
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Taxonomy Code | 213E00000X
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Taxonomy Name | Podiatrist
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License Number | DPM.PD314R
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License Number State | LA
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