Provider Demographics
NPI:1184838716
Name:PERDUE, LOUIS DONOVAN JR (MD)
Entity Type:Individual
Prefix:DR
First Name:LOUIS
Middle Name:DONOVAN
Last Name:PERDUE
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:4315 HOUMA BLVD
Mailing Address - Street 2:SUITE 303
Mailing Address - City:METAIRIE
Mailing Address - State:LA
Mailing Address - Zip Code:70006-2940
Mailing Address - Country:US
Mailing Address - Phone:504-889-5242
Mailing Address - Fax:504-780-9251
Practice Address - Street 1:4315 HOUMA BLVD
Practice Address - Street 2:SUITE 303
Practice Address - City:METAIRIE
Practice Address - State:LA
Practice Address - Zip Code:70006-2940
Practice Address - Country:US
Practice Address - Phone:504-889-5242
Practice Address - Fax:504-780-9251
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-10
Last Update Date:2023-10-17
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
LAMD.205237207RR0500X
LA205237207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA12375719OtherCAQH
LA2341235Medicaid