Provider Demographics
NPI:1477522068
Name:DUPLECHAIN, JESSE KEVIN (MD II APMC)
Entity Type:Individual
Prefix:
First Name:JESSE
Middle Name:KEVIN
Last Name:DUPLECHAIN
Suffix:
Gender:M
Credentials:MD II APMC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
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
Practice Address - Street 2:SUITE 300
Practice Address - City:LAFAYETTE
Practice Address - State:LA
Practice Address - Zip Code:70508-5705
Practice Address - Country:US
Practice Address - Phone:337-456-3282
Practice Address - Fax:337-456-3491
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-16
Last Update Date:2020-11-23
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
LA018195207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1372889Medicaid
LA1372889Medicaid
54350F652Medicare PIN