Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 1223D0001X | Dental Public Health | 6603 | LA |
Y | 1223G0001X | General Practice | 6603 | LA |
Y | 213EG0000X | General Practice | 6603 | LA |
NPI | 1316315401 |
---|---|
Provider Name | Dr. Douglas Rodrigue JR. |
First Address | New Orleans, LA 70116-2084 |
Second Address | New Orleans, LA 70130-3626 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 08/09/2015 |
Last Update Date | 13/01/2021 |