Individual
MALCOLM MICHAEL DUPLANTIS JR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
04755
LA
225100000X
Physical Therapist
Primary
04755
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4B693C811
MEDICARE GROUP MEMBER PTAN
LA
01
—
5C811
MEDICARD GROUP PTAN
LA
01
—
721460193
TAX ID PT AND HAND CENTER
LA
Enumeration date
07/02/2007
Last updated
08/08/2012
Update your record
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