Provider Demographics
NPI:1285612150
Name:DUFRENE, JR., MERIL JOSEPH (DC)
Entity type:Individual
Prefix:DR
First Name:MERIL
Middle Name:JOSEPH
Last Name:DUFRENE, JR.
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3327 JACKSON ST
Mailing Address - Street 2:SUITE F
Mailing Address - City:ALEXANDRIA
Mailing Address - State:LA
Mailing Address - Zip Code:71301-3372
Mailing Address - Country:US
Mailing Address - Phone:318-445-2513
Mailing Address - Fax:318-445-2910
Practice Address - Street 1:3327 JACKSON ST
Practice Address - Street 2:SUITE F
Practice Address - City:ALEXANDRIA
Practice Address - State:LA
Practice Address - Zip Code:71301-3372
Practice Address - Country:US
Practice Address - Phone:318-445-2513
Practice Address - Fax:318-445-2910
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-02
Last Update Date:2009-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA761111NS0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NS0005XChiropractic ProvidersChiropractorSports Physician
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA3079AOtherBLUE CROSS/BLUE SHIELD
LAT20015Medicare UPIN
LA3079AOtherBLUE CROSS/BLUE SHIELD