Provider Demographics
NPI:1083899173
Name:LUCIUS J. DOUCET, III, MD, LLC
Entity Type:Organization
Organization Name:LUCIUS J. DOUCET, III, MD, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:MICHELLE
Authorized Official - Middle Name:R
Authorized Official - Last Name:LABORDE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:225-810-3911
Mailing Address - Street 1:8490 PICARDY AVE
Mailing Address - Street 2:BLDG 600 B
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70809-3731
Mailing Address - Country:US
Mailing Address - Phone:225-810-3911
Mailing Address - Fax:225-810-3954
Practice Address - Street 1:8490 PICARDY AVE
Practice Address - Street 2:BLDG 600 B
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70809-3731
Practice Address - Country:US
Practice Address - Phone:225-810-3911
Practice Address - Fax:225-810-3954
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-08
Last Update Date:2012-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAMD.019318174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1639177348Medicare NSC
LA1083899173Medicare NSC
LA5U384DC22Medicare PIN
LA5DC22Medicare PIN