Provider Demographics
NPI:1437794096
Name:JESSE KEVIN DUPLECHAIN MD II A PROFESSIONAL MEDICAL CORPORATION
Entity Type:Organization
Organization Name:JESSE KEVIN DUPLECHAIN MD II A PROFESSIONAL MEDICAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JESSE
Authorized Official - Middle Name:KEVIN
Authorized Official - Last Name:DUPLECHAIN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:337-456-3282
Mailing Address - Street 1:1103 KALISTE SALOOM RD STE 300
Mailing Address - Street 2:
Mailing Address - City:LAFAYETTE
Mailing Address - State:LA
Mailing Address - Zip Code:70508-5784
Mailing Address - Country:US
Mailing Address - Phone:337-456-3282
Mailing Address - Fax:337-456-3491
Practice Address - Street 1:1103 KALISTE SALOOM RD STE 300
Practice Address - Street 2:
Practice Address - City:LAFAYETTE
Practice Address - State:LA
Practice Address - Zip Code:70508-5784
Practice Address - Country:US
Practice Address - Phone:337-456-3282
Practice Address - Fax:337-456-3491
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-11-07
Last Update Date:2020-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic SurgeryGroup - Single Specialty