Provider Demographics
NPI:1528195765
Name:PLAUCHE, WARREN JOHN (MD)
Entity Type:Individual
Prefix:DR
First Name:WARREN
Middle Name:JOHN
Last Name:PLAUCHE
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 86
Mailing Address - Street 2:
Mailing Address - City:PLAUCHEVILLE
Mailing Address - State:LA
Mailing Address - Zip Code:71362
Mailing Address - Country:US
Mailing Address - Phone:318-253-0866
Mailing Address - Fax:318-253-0864
Practice Address - Street 1:7406 HIGHWAY 1 STE 103
Practice Address - Street 2:
Practice Address - City:MANSURA
Practice Address - State:LA
Practice Address - Zip Code:71350-4230
Practice Address - Country:US
Practice Address - Phone:318-739-0086
Practice Address - Fax:877-325-2708
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-27
Last Update Date:2022-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA019604207Q00000X, 208M00000X
LA1047541960207Q00000X
LAMD019604207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1378976Medicaid
LAP00463035Medicare PIN
LA5J992Medicare PIN
LAD87005Medicare UPIN