Provider Demographics
NPI:1740340629
Name:MARIA T. DOUCET, M.D., A.P.M.C.
Entity type:Organization
Organization Name:MARIA T. DOUCET, M.D., A.P.M.C.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRACTICE ADMINISTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:PAIGE
Authorized Official - Middle Name:R
Authorized Official - Last Name:CROCHET
Authorized Official - Suffix:
Authorized Official - Credentials:RHIA
Authorized Official - Phone:337-989-4453
Mailing Address - Street 1:4630 AMBASSADOR CAFFERY PKWY
Mailing Address - Street 2:BLDG. A, SUITE 402
Mailing Address - City:LAFAYETTE
Mailing Address - State:LA
Mailing Address - Zip Code:70508-6949
Mailing Address - Country:US
Mailing Address - Phone:337-989-4453
Mailing Address - Fax:337-989-2289
Practice Address - Street 1:4630 AMBASSADOR CAFFERY PKWY
Practice Address - Street 2:BLDG. A, SUITE 402
Practice Address - City:LAFAYETTE
Practice Address - State:LA
Practice Address - Zip Code:70508-6949
Practice Address - Country:US
Practice Address - Phone:337-989-4453
Practice Address - Fax:337-989-2289
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-11
Last Update Date:2013-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1683094Medicaid
LA1683094Medicaid
LA5W620Medicare PIN