Provider Demographics
NPI:1629039839
Name:DAUL, GEORGE C JR (MD)
Entity Type:Individual
Prefix:DR
First Name:GEORGE
Middle Name:C
Last Name:DAUL
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:1529 RIVER OAKS RD W
Mailing Address - Street 2:SUITE 123
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70123-2162
Mailing Address - Country:US
Mailing Address - Phone:504-729-4414
Mailing Address - Fax:504-729-4415
Practice Address - Street 1:1529 RIVER OAKS RD W
Practice Address - Street 2:SUITE 123
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70123-2162
Practice Address - Country:US
Practice Address - Phone:504-729-4414
Practice Address - Fax:504-729-4415
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-03-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA27932084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA5K216Medicare ID - Type Unspecified
LA1162272Medicare UPIN