Provider Demographics
NPI:1417975756
Name:DUPLECHAIN, MICHAEL (MD)
Entity Type:Individual
Prefix:
First Name:MICHAEL
Middle Name:
Last Name:DUPLECHAIN
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 1:18169 E PETROLEUM DR
Mailing Address - Street 2:BUILDING 9
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70809-6104
Mailing Address - Country:US
Mailing Address - Phone:225-765-5247
Mailing Address - Fax:225-490-7516
Practice Address - Street 1:18169 E PETROLEUM DR
Practice Address - Street 2:BLDG 9
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70809-6104
Practice Address - Country:US
Practice Address - Phone:225-765-5247
Practice Address - Fax:225-490-7516
Is Sole Proprietor?:No
Enumeration Date:2006-07-17
Last Update Date:2009-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA025964207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
LAP00329239OtherRRM
LA1057215Medicaid
LA4J479CQ60Medicare PIN
LA1057215Medicaid
LA4J479D279Medicare PIN
LA4J479CN33Medicare PIN
LAI27412Medicare UPIN