Provider Demographics
NPI:1235302613
Name:DOUCIERE, RICHARD FRED
Entity Type:Individual
Prefix:
First Name:RICHARD
Middle Name:FRED
Last Name:DOUCIERE
Suffix:
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 1:516 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:DELHI
Mailing Address - State:LA
Mailing Address - Zip Code:71232-2538
Mailing Address - Country:US
Mailing Address - Phone:318-878-2405
Mailing Address - Fax:318-878-8968
Practice Address - Street 1:516 MAIN ST
Practice Address - Street 2:
Practice Address - City:DELHI
Practice Address - State:LA
Practice Address - Zip Code:71232-2538
Practice Address - Country:US
Practice Address - Phone:318-878-2405
Practice Address - Fax:318-878-8968
Is Sole Proprietor?:No
Enumeration Date:2008-04-08
Last Update Date:2008-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA39451223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice