Provider Demographics
NPI:1932129095
Name:MILLET, JOSEPH RALPH JR (MD)
Entity Type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:RALPH
Last Name:MILLET
Suffix:JR
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 1:80 GARDENIA DRIVE
Mailing Address - Street 2:SUITE B
Mailing Address - City:COVINGTON
Mailing Address - State:LA
Mailing Address - Zip Code:70443
Mailing Address - Country:US
Mailing Address - Phone:985-871-5900
Mailing Address - Fax:985-871-5901
Practice Address - Street 1:80 GARDENIA DRIVE
Practice Address - Street 2:SUITE B
Practice Address - City:COVINGTON
Practice Address - State:LA
Practice Address - Zip Code:70443
Practice Address - Country:US
Practice Address - Phone:985-871-5900
Practice Address - Fax:985-871-5901
Is Sole Proprietor?:No
Enumeration Date:2006-07-20
Last Update Date:2012-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA011873207R00000X
LA056135206207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1144991Medicaid
LA1144991Medicaid
53068Medicare PIN
530680347Medicare PIN