Individual
DR. DUANE WILLIAM SUPERNEAU
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
8415 GOODWOOD BLVD, SUITE 202 B, BATON ROUGE, LA 70806-7851
(225) 765-8988
(225) 765-1173
Mailing address
8415 GOODWOOD BLVD, SUITE 202 B, BATON ROUGE, LA 70806-7851
(225) 765-8988
(225) 765-1173
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
14531
LA
207SG0201X
Clinical Genetics (M.D.) Physician
Primary
MD.014531
LA
208000000X
Pediatrics Physician
MD014531
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00119789
—
MS
05
—
1907421
—
LA
Enumeration date
03/24/2006
Last updated
04/27/2021
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