Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207QA0401X | Family Doctor - Addiction Medicine | 13353 | LA |
N | 207RA0401X | Internist - Addiction Medicine | MD.013353 | LA |
NPI | 1356363428 |
---|---|
Provider Name | Dr. John Cedric Dauphin |
First Address | Lafayette, LA 70506-3008 |
Second Address | Lafayette, LA 70501-1884 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/07/2006 |
Last Update Date | 23/05/2019 |