Provider Demographics
NPI:1174675086
Name:DEDON, LOUIS E (DO)
Entity type:Individual
Prefix:
First Name:LOUIS
Middle Name:E
Last Name:DEDON
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
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Mailing Address - Street 1:229 BELLEMEADE BLVD
Mailing Address - Street 2:SUITE 301
Mailing Address - City:GRETNA
Mailing Address - State:LA
Mailing Address - Zip Code:70056-7153
Mailing Address - Country:US
Mailing Address - Phone:225-235-3862
Mailing Address - Fax:504-398-4337
Practice Address - Street 1:110 ESKEW DR
Practice Address - Street 2:BUILDING 2
Practice Address - City:ALEXANDRIA
Practice Address - State:LA
Practice Address - Zip Code:71303-3763
Practice Address - Country:US
Practice Address - Phone:318-445-5111
Practice Address - Fax:318-442-2261
Is Sole Proprietor?:No
Enumeration Date:2007-01-18
Last Update Date:2013-03-04
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
LA08089R2084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1914860Medicaid
LAE69809Medicare UPIN
LA1914860Medicaid