Provider Demographics
NPI:1306945977
Name:DONALD W DOUCET MD AND ASSOCIATES LLC
Entity type:Organization
Organization Name:DONALD W DOUCET MD AND ASSOCIATES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:DONALD
Authorized Official - Middle Name:W
Authorized Official - Last Name:DOUCET
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:225-638-4585
Mailing Address - Street 1:PO BOX 530
Mailing Address - Street 2:
Mailing Address - City:NEW ROADS
Mailing Address - State:LA
Mailing Address - Zip Code:70760-0530
Mailing Address - Country:US
Mailing Address - Phone:225-638-4585
Mailing Address - Fax:225-638-4586
Practice Address - Street 1:230 ROBERTS DR
Practice Address - Street 2:SUITE I
Practice Address - City:NEW ROADS
Practice Address - State:LA
Practice Address - Zip Code:70760-2661
Practice Address - Country:US
Practice Address - Phone:225-638-4585
Practice Address - Fax:225-638-4586
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-21
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1948268Medicaid
LA5C320Medicare ID - Type UnspecifiedGROUP ID