Provider Demographics
NPI:1275587016
Name:PLAUCHE, JOSEPH TODD
Entity Type:Individual
Prefix:
First Name:JOSEPH
Middle Name:TODD
Last Name:PLAUCHE
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 1:116 JJJ LN
Mailing Address - Street 2:
Mailing Address - City:SIMMESPORT
Mailing Address - State:LA
Mailing Address - Zip Code:71369-2180
Mailing Address - Country:US
Mailing Address - Phone:318-941-2296
Mailing Address - Fax:
Practice Address - Street 1:116 JJJ LN
Practice Address - Street 2:
Practice Address - City:SIMMESPORT
Practice Address - State:LA
Practice Address - Zip Code:71369-2180
Practice Address - Country:US
Practice Address - Phone:318-941-2296
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA15534183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1266663Medicaid
LA1928641OtherNABP