Individual
DR. JOHN DEBACK JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
7777 HENNESSY BLVD, SUITE 6000, BATON ROUGE, LA 70808-4300
(225) 765-8648
(225) 765-7898
Mailing address
7777 HENNESSY BLVD, SUITE 6000, BATON ROUGE, LA 70808-4300
(225) 765-8648
(225) 765-7898
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
17013
LA
2084P0804X
Child & Adolescent Psychiatry Physician
017013
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1356387
—
LA
Enumeration date
07/28/2005
Last updated
03/25/2021
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