Individual
CHARLES EDWARD DEDEAUX JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
7373 PERKINS RD, BATON ROUGE, LA 70808
(225) 769-4044
(225) 246-9116
Mailing address
7373 PERKINS RD, BATON ROUGE, LA 70808-4373
(225) 246-9790
(225) 246-9100
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
308373
LA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/07/2015
Last updated
10/29/2019
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