Provider Demographics
NPI:1396940466
Name:DEFRANCESCH, DAMIAN ANGELO (MD)
Entity type:Individual
Prefix:DR
First Name:DAMIAN
Middle Name:ANGELO
Last Name:DEFRANCESCH
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 2067
Mailing Address - Street 2:
Mailing Address - City:NATCHITOCHES
Mailing Address - State:LA
Mailing Address - Zip Code:71457-2067
Mailing Address - Country:US
Mailing Address - Phone:318-354-2555
Mailing Address - Fax:318-354-0101
Practice Address - Street 1:501 KEYSER AVE
Practice Address - Street 2:
Practice Address - City:NATCHITOCHES
Practice Address - State:LA
Practice Address - Zip Code:71457-6018
Practice Address - Country:US
Practice Address - Phone:318-354-2555
Practice Address - Fax:318-354-0101
Is Sole Proprietor?:No
Enumeration Date:2007-06-19
Last Update Date:2021-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAMD.207084208600000X, 2086S0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
No2086S0102XAllopathic & Osteopathic PhysiciansSurgerySurgical Critical Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA2372297Medicaid
LA2372297Medicaid