Provider Demographics
NPI:1245241686
Name:SALOPEK, JR., STEPHEN ROBERT (MD)
Entity Type:Individual
Prefix:DR
First Name:STEPHEN
Middle Name:ROBERT
Last Name:SALOPEK, JR.
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 53788
Mailing Address - Street 2:
Mailing Address - City:LAFAYETTE
Mailing Address - State:LA
Mailing Address - Zip Code:70505-3788
Mailing Address - Country:US
Mailing Address - Phone:337-232-1010
Mailing Address - Fax:337-234-3591
Practice Address - Street 1:155 HOSPITAL DR STE 200
Practice Address - Street 2:
Practice Address - City:LAFAYETTE
Practice Address - State:LA
Practice Address - Zip Code:70503-2852
Practice Address - Country:US
Practice Address - Phone:337-232-1010
Practice Address - Fax:337-234-3591
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-10
Last Update Date:2022-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA023853207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1485675Medicaid
LA5E023Medicare ID - Type Unspecified
LA1485675Medicaid