Provider Demographics
NPI:1508805532
Name:DUPREE, ERIC CHARLES (MD)
Entity Type:Individual
Prefix:DR
First Name:ERIC
Middle Name:CHARLES
Last Name:DUPREE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:ERIC
Other - Middle Name:CHARLES
Other - Last Name:DUPREE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:639 W LAFAYETTE ST
Mailing Address - Street 2:
Mailing Address - City:WINNFIELD
Mailing Address - State:LA
Mailing Address - Zip Code:71483-3451
Mailing Address - Country:US
Mailing Address - Phone:318-648-2220
Mailing Address - Fax:318-648-2270
Practice Address - Street 1:639 W LAFAYETTE ST
Practice Address - Street 2:
Practice Address - City:WINNFIELD
Practice Address - State:LA
Practice Address - Zip Code:71483-3451
Practice Address - Country:US
Practice Address - Phone:318-648-2220
Practice Address - Fax:318-648-2270
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-05
Last Update Date:2011-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAL024984207Q00000X
LAMD.024984207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1422983Medicaid
LAH92771Medicare UPIN
LA1422983Medicaid
LA4F390DJ97Medicare PIN