Provider Demographics
NPI:1164567541
Name:DUPONT, JAMES DOUGLAS SR
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:DOUGLAS
Last Name:DUPONT
Suffix:SR
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1260 LAKE DR
Mailing Address - Street 2:
Mailing Address - City:WOODWORTH
Mailing Address - State:LA
Mailing Address - Zip Code:71485-9728
Mailing Address - Country:US
Mailing Address - Phone:318-487-4080
Mailing Address - Fax:
Practice Address - Street 1:3311 PRESCOTT RD STE 202
Practice Address - Street 2:
Practice Address - City:ALEXANDRIA
Practice Address - State:LA
Practice Address - Zip Code:71301-3983
Practice Address - Country:US
Practice Address - Phone:318-442-0106
Practice Address - Fax:318-442-8151
Is Sole Proprietor?:No
Enumeration Date:2007-02-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAPEF.200014246X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246X00000XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist Cardiovascular