Provider Demographics
NPI:1043271828
Name:DUPREE, DANIEL GAINES (MD)
Entity Type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:GAINES
Last Name:DUPREE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:1101 SOUTH COLLEGE RD
Mailing Address - Street 2:SUITE 202
Mailing Address - City:LAFAYETTE
Mailing Address - State:LA
Mailing Address - Zip Code:70503
Mailing Address - Country:US
Mailing Address - Phone:337-235-6886
Mailing Address - Fax:337-235-6892
Practice Address - Street 1:1101 SOUTH COLLEGE RD
Practice Address - Street 2:SUITE 202
Practice Address - City:LAFAYETTE
Practice Address - State:LA
Practice Address - Zip Code:70503
Practice Address - Country:US
Practice Address - Phone:337-235-6886
Practice Address - Fax:337-235-6892
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-03-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
LA012704207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1185426Medicaid
51485Medicare ID - Type Unspecified
LA1185426Medicaid