Provider Demographics
NPI:1457067951
Name:PLAUCHE, MICHAEL THOMAS
Entity Type:Individual
Prefix:
First Name:MICHAEL
Middle Name:THOMAS
Last Name:PLAUCHE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3299 HIGHWAY 107 S
Mailing Address - Street 2:
Mailing Address - City:PLAUCHEVILLE
Mailing Address - State:LA
Mailing Address - Zip Code:71362-2028
Mailing Address - Country:US
Mailing Address - Phone:337-853-0282
Mailing Address - Fax:
Practice Address - Street 1:3299 HIGHWAY 107 S
Practice Address - Street 2:
Practice Address - City:PLAUCHEVILLE
Practice Address - State:LA
Practice Address - Zip Code:71362-2028
Practice Address - Country:US
Practice Address - Phone:337-853-0282
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-01-27
Last Update Date:2023-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA45241342K332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies