Provider Demographics
NPI:1912394545
Name:DUCHAMP, NICOLAS SCOTT (MD)
Entity Type:Individual
Prefix:DR
First Name:NICOLAS
Middle Name:SCOTT
Last Name:DUCHAMP
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:5246 BRITTANY DR
Mailing Address - Street 2:SUITE 304
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70808-9136
Mailing Address - Country:US
Mailing Address - Phone:225-757-4140
Mailing Address - Fax:225-757-4230
Practice Address - Street 1:5246 BRITTANY DR
Practice Address - Street 2:SUITE 304
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70808-9136
Practice Address - Country:US
Practice Address - Phone:225-757-4140
Practice Address - Fax:225-757-4230
Is Sole Proprietor?:No
Enumeration Date:2015-04-21
Last Update Date:2019-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
LA306011207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program