Provider Demographics
NPI:1194918557
Name:WARREN J. PLAUCHE, M.D., PC
Entity type:Organization
Organization Name:WARREN J. PLAUCHE, M.D., PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:WARREN
Authorized Official - Middle Name:J
Authorized Official - Last Name:PLAUCHE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:318-305-7000
Mailing Address - Street 1:PO BOX 86
Mailing Address - Street 2:
Mailing Address - City:PLAUCHEVILLE
Mailing Address - State:LA
Mailing Address - Zip Code:71362-0086
Mailing Address - Country:US
Mailing Address - Phone:318-922-3715
Mailing Address - Fax:
Practice Address - Street 1:3319 HIGHWAY 107 S
Practice Address - Street 2:
Practice Address - City:PLAUCHEVILLE
Practice Address - State:LA
Practice Address - Zip Code:71362-2030
Practice Address - Country:US
Practice Address - Phone:318-739-0086
Practice Address - Fax:877-325-2708
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-20
Last Update Date:2021-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA2319931Medicaid
LA5DC20Medicare PIN