Provider Demographics
NPI:1528421872
Name:PITRE, JOSHUA MARK (MD)
Entity type:Individual
Prefix:
First Name:JOSHUA
Middle Name:MARK
Last Name:PITRE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7373 PERKINS RD
Mailing Address - Street 2:
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70808-4373
Mailing Address - Country:US
Mailing Address - Phone:225-246-9916
Mailing Address - Fax:225-246-4011
Practice Address - Street 1:7373 PERKINS RD
Practice Address - Street 2:
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70808-4373
Practice Address - Country:US
Practice Address - Phone:225-246-9916
Practice Address - Fax:225-246-4011
Is Sole Proprietor?:No
Enumeration Date:2016-04-04
Last Update Date:2023-04-13
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
LA312410207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA2414232Medicaid