Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207P00000X | Emergency Physician | 016657 | LA |
Y | 208D00000X | General Practice Physician | MD.016647 | LA |
NPI | 1043234602 |
---|---|
Provider Name | Dr. Lovelace Joseph Luquette JR. |
First Address | Lafayette, LA 70503-5408 |
Second Address | Lafayette, LA 70503-5408 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 27/07/2006 |
Last Update Date | 20/05/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1328839 | (05) | LA |
P00980763 | MCARE RR (01) | LA |