Individual
DEDRIC J CLARKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
602 N. ACADIA ROAD, SUITE 101, THIBODAUX, LA 70301
(985) 493-4993
(985) 493-4994
Mailing address
602 N. ACADIA ROAD, SUITE 101, THIBODAUX, LA 70301
(985) 493-4993
(985) 493-4994
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
200764
LA
207RC0001X
Clinical Cardiac Electrophysiology Physician
Primary
MD.200764
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1066885
—
LA
Enumeration date
07/26/2007
Last updated
03/06/2026
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