Provider Demographics
NPI:1417982422
Name:MENARD, DARRIN D (MD)
Entity Type:Individual
Prefix:DR
First Name:DARRIN
Middle Name:D
Last Name:MENARD
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 580
Mailing Address - Street 2:
Mailing Address - City:SCOTT
Mailing Address - State:LA
Mailing Address - Zip Code:70583
Mailing Address - Country:US
Mailing Address - Phone:337-232-1802
Mailing Address - Fax:337-232-1809
Practice Address - Street 1:202 WESTGATE RD
Practice Address - Street 2:
Practice Address - City:LAFAYETTE
Practice Address - State:LA
Practice Address - Zip Code:70506
Practice Address - Country:US
Practice Address - Phone:337-232-1802
Practice Address - Fax:337-232-1809
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-11
Last Update Date:2020-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA022688207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1492078Medicaid
LA5Y564Medicare ID - Type Unspecified
LA1492078Medicaid