Provider Demographics
NPI:1780877431
Name:TOUPS, JUSTIN PAUL (MD)
Entity type:Individual
Prefix:
First Name:JUSTIN
Middle Name:PAUL
Last Name:TOUPS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:602 N ACADIA RD
Mailing Address - Street 2:STE. 101
Mailing Address - City:THIBODAUX
Mailing Address - State:LA
Mailing Address - Zip Code:70301-4847
Mailing Address - Country:US
Mailing Address - Phone:985-446-1958
Mailing Address - Fax:985-446-0121
Practice Address - Street 1:602 N ACADIA RD
Practice Address - Street 2:STE. 101
Practice Address - City:THIBODAUX
Practice Address - State:LA
Practice Address - Zip Code:70301-4847
Practice Address - Country:US
Practice Address - Phone:985-446-1958
Practice Address - Fax:985-446-0121
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-24
Last Update Date:2013-09-26
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
LA202187207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1007382Medicaid
LA5CR42Medicare PIN