Provider Demographics
NPI:1023176989
Name:CAMPEAU, RICHARD JOHN JR (MD)
Entity type:Individual
Prefix:
First Name:RICHARD
Middle Name:JOHN
Last Name:CAMPEAU
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5316 DRYADES ST
Mailing Address - Street 2:
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70115-4947
Mailing Address - Country:US
Mailing Address - Phone:504-897-4159
Mailing Address - Fax:504-891-6727
Practice Address - Street 1:5316 DRYADES ST
Practice Address - Street 2:
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70115-4947
Practice Address - Country:US
Practice Address - Phone:504-897-4159
Practice Address - Fax:504-891-6727
Is Sole Proprietor?:No
Enumeration Date:2006-12-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LALA011223207U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207U00000XAllopathic & Osteopathic PhysiciansNuclear Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA0115832Medicaid
LA01168432OtherLA CAID
LA0115832Medicaid
B60467Medicare UPIN