Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207N00000X | Dermatologist | 012704 | LA |
NPI | 1043271828 |
---|---|
Provider Name | Dr. Daniel Gaines Dupree |
First Address | Lafayette, LA 70503 |
Second Address | Lafayette, LA 70503 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 31/03/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1185426 | (05) | LA |
B63104 | (02) |