NPI 1659767713

Dustin Dorsey

Practitioner PACE Provider Organization Lafayette, LA

Practice location

Address: 203 Hallmark Ave, Lafayette, LA 70508-7766
Phone: (337) 356-8050

Registered specialties

PACE Provider Organization Primary

Agencies Taxonomy 251T00000X Licence 47-1407033 (LA)

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Registry record

NPI: 1659767713
Entity type: Individual
Sex (as registered): Male
NPI issued: 15 Apr 2015
Record last updated: 15 Apr 2015

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.