Provider Demographics
NPI:1902806128
Name:CURTIS, DWIGHT THOMAS (MD)
Entity type:Individual
Prefix:
First Name:DWIGHT
Middle Name:THOMAS
Last Name:CURTIS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:D
Other - Middle Name:THOMAS
Other - Last Name:CURTIS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:717 CURTIS DR
Mailing Address - Street 2:
Mailing Address - City:RAYNE
Mailing Address - State:LA
Mailing Address - Zip Code:70578-8311
Mailing Address - Country:US
Mailing Address - Phone:337-334-7551
Mailing Address - Fax:337-334-7556
Practice Address - Street 1:717 CURTIS DR
Practice Address - Street 2:
Practice Address - City:RAYNE
Practice Address - State:LA
Practice Address - Zip Code:70578-8311
Practice Address - Country:US
Practice Address - Phone:337-334-7551
Practice Address - Fax:337-334-7556
Is Sole Proprietor?:No
Enumeration Date:2005-07-29
Last Update Date:2022-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAL018185207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1352365Medicaid
LA50777Medicare ID - Type Unspecified
LA1352365Medicaid