Provider Demographics
NPI:1861460982
Name:DUPLECHAIN, STEPHEN C (MD)
Entity Type:Individual
Prefix:
First Name:STEPHEN
Middle Name:C
Last Name:DUPLECHAIN
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 1:602 N ACADIA RD
Mailing Address - Street 2:SUITE 101
Mailing Address - City:THIBODAUX
Mailing Address - State:LA
Mailing Address - Zip Code:70301-4847
Mailing Address - Country:US
Mailing Address - Phone:985-446-1958
Mailing Address - Fax:985-446-0121
Practice Address - Street 1:602 N ACADIA RD
Practice Address - Street 2:SUITE 101
Practice Address - City:THIBODAUX
Practice Address - State:LA
Practice Address - Zip Code:70301-4847
Practice Address - Country:US
Practice Address - Phone:985-446-1958
Practice Address - Fax:985-446-0121
Is Sole Proprietor?:No
Enumeration Date:2006-03-14
Last Update Date:2012-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA10530R207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1992798Medicaid
LAF86597Medicare UPIN
LA5U559Medicare ID - Type Unspecified