MEDICARE: GREGORY DUPLECHAIN M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Y00000X	Otolaryngology Physician	020465	LA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1083683601
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	GREGORY DUPLECHAIN M.D.

Provider Business Mailing Address
First Line	:	PO BOX 52068
Second Line	:
City	:	LAFAYETTE
State	:	LA
Zip	:	70505-2068
Country	:	US
Telephone Number	:	337-233-7174
Fax Number	:	337-269-0981

Provider Business Practice Location Address
First Line	:	4809 AMBASSADOR CAFFERY PKWY
Second Line	:	SUITE 260
City	:	LAFAYETTE
State	:	LA
Zip	:	70508-8800
Country	:	US
Telephone Number	:	337-456-1106
Fax Number	:	337-456-1108

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/16/2006
Last Update Date	:	01/17/2014

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