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Individual

DR. JOHN DAVID DE LAPP

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
500 S 6TH ST STE A, LEESVILLE, LA 71446-4442
(337) 239-8000
(337) 239-8003
Mailing address
500 S 6TH ST STE A, LEESVILLE, LA 71446-4442
(337) 239-8000
(337) 239-8003

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
12067R
LA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
12067R
LA STATE LICENSE
LA
05
1699683
LA
01
25774
CONTROL DANGER SUBSTANCE
LA
01
94-3311887
TAX ID #
Enumeration date
02/27/2006
Last updated
06/22/2012
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