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Individual

KEITH J LUPER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DPM

Contact information

Practice address
2750 EAST GAUSE BLVD., SLIDELL, LA 70461
(985) 639-3777
Mailing address
1514 JEFFERSON HIGHWAY, NEW ORLEANS, LA 70121
(504) 842-4000

Taxonomy

Speciality
Code
Description
License number
State
213E00000X
Podiatrist
266
AL
213E00000X
Podiatrist
Primary
DPM.PD314R
LA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
02783285
MS
05
1888214
LA
05
3354056
TN
01
51524600
BCBS
AL
Enumeration date
12/09/2006
Last updated
02/23/2010
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