Individual
DR. JOSEPH BENTON DUPONT JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3401 NORTH BLVD, SUITE 200-B, BATON ROUGE, LA 70806-3743
(225) 381-2615
(225) 381-2638
Mailing address
8490 PICARDY AVE, BLDG 200, BATON ROUGE, LA 70809-3731
(225) 237-1754
(225) 237-1722
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
MD012268
LA
2086X0206X
Surgical Oncology Physician
MD012268
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1196177
—
LA
01
—
270476YUB6
MEDICARE PTAN
LA
01
—
5DG10
MEDICARE GROUP PTAN
LA
Enumeration date
07/25/2006
Last updated
06/16/2014
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