DR. DUANE WILLIAM SUPERNEAU (NPI# 1427018274) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1427018274 |
| Entity Type | Individual |
| Full Name | DR. DUANE WILLIAM SUPERNEAU |
| Credential | M.D. |
| Practice Address |
8415 Goodwood Blvd Suite 202 B Baton Rouge LA 70806-7851 |
| Practice Telephone | 2257658988 |
| Practice Fax Number | 2257651173 |
| Mailing Telephone | 2257658988 |
| Mailing Fax Number | 2257651173 |
| Enumeration Date | 2006-03-24 |
| Last Update Date | 2013-10-25 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 174400000X | Specialist | 14531 | LA | Other Service Providers |
| Y | 207SG0201X |
Medical Genetics Specialization: Clinical Genetics (M.D.) |
MD.014531 | LA | Allopathic & Osteopathic Physicians |
| N | 208000000X | Pediatrics | MD014531 | LA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MS | 00119789 | 05 | |
| LA | 1907421 | 05 |
| Street Address |
8415 GOODWOOD BLVD SUITE 202 B |
| City | BATON ROUGE |
| State | LA |
| Zip Code | 70806-7851 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033118443 | Horace Jay Collinsworth | Pediatrics | 8415 Goodwood Blvd, Suite 100, Baton Rouge, LA 70806-7851 | 2005-07-18 |
| 1386053031 | Nicole Dinh | Pediatrics | 8415 Goodwood Blvd, Ste. 202, Baton Rouge, LA 70806-7851 | 2014-08-07 |
| 1740697374 | David Benjamin Holmes | Student in an Organized Health Care Education/Training Program | 8415 Goodwood Blvd, Ste. 202, Baton Rouge, LA 70806-7851 | 2014-07-15 |
| 1699181966 | Alma Rosibel Cruz | Allergy & Immunology | 8415 Goodwood Blvd, Ste 202, Baton Rouge, LA 70806-7851 | 2014-07-08 |
| 1326454521 | Hunter Thomas Hamilton | Pediatrics | 8415 Goodwood Blvd, Ste 202, Baton Rouge, LA 70806-7851 | 2014-07-08 |
| 1447682802 | Mary Beth Mazza-ricketts | Nurse Practitioner | 8415 Goodwood Blvd, Suite 100, Baton Rouge, LA 70806-7851 | 2013-08-07 |
| 1497010532 | Sylvia M Sutton | Pediatrics | 8415 Goodwood Blvd, Baton Rouge, LA 70806-7851 | 2012-07-04 |
| 1891094603 | Meagan Teal Blanchard | Pediatrics | 8415 Goodwood Blvd, Suite 104, Baton Rouge, LA 70806-7851 | 2011-03-18 |
| 1356643399 | Our Lady of The Lake Physician Group LLC | Internal Medicine | 8415 Goodwood Blvd, Ste 105, Baton Rouge, LA 70806-7851 | 2010-11-24 |
| 1417184110 | Roberta Carona Vicari | Pediatrics | 8415 Goodwood Blvd, Suite 202, Baton Rouge, LA 70806-7851 | 2009-06-19 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467064790 | Horizon Network LLC | Community/Behavioral Health | 921 Lobdell Blvd Suite D, Baton Rouge, LA 70806 | 2020-08-18 |
| 1093324220 | Raghu Rudraraju | Student in an Organized Health Care Education/Training Program | 3401 North Boulevard Baton Rouge General Mid City Medi, Suite 130, Baton Rouge, LA 70806 | 2020-07-23 |
| 1619595584 | Brown's Pharmacy, LLC | Pharmacy | 1718 North Foster Drive, Suite B, Baton Rouge, LA 70806 | 2020-07-08 |
| 1497374847 | Yara Mouawad | Student in an Organized Health Care Education/Training Program | 3401 North Boulevard, Suite 130, Baton Rouge, LA 70806 | 2020-04-15 |
| 1396364527 | Sai Samyuktha Bandaru | Student in an Organized Health Care Education/Training Program | Brg Mid City Medicine Clinic, 3401 North Boulevard, Sui, Baton Rouge, LA 70806 | 2020-04-08 |
| 1588299812 | Iraneeka S Gustave | Peer Specialist | Kelwood Ave, 8326 Kelwood Ave, Baton Rouge, LA 70806 | 2020-03-06 |
| 1518522192 | Silpita Katragadda | Student in an Organized Health Care Education/Training Program | 3401 North Boulevard, Brg Midcity Medicine Clinic, Suite 130, Baton Rouge, LA 70806 | 2019-05-08 |
| 1437713997 | Dental Solutions, LLC | Dentist | 5629 Government St, Baton Rouge, LA 70806 | 2019-04-30 |
| 1699249516 | Shea Lafountain | Counselor | 624 Connell's Park Lane, Baton Rouge, LA 70806 | 2019-01-14 |
| 1033682802 | Genesis Specialty Groups, LLC | Clinic/Center | 778 Chevelle Drive, Baton Rouge, LA 70806 | 2019-01-04 |
| Find all providers in zip 70806 | ||||
| Taxonomy Code | 207SG0201X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Medical Genetics |
| Specialization | Clinical Genetics (M.D.) |
| A clinical geneticist demonstrates competence in providing comprehensive diagnostic, management and counseling services for genetic disorders. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added] Additional Resources: American Board of Medical Genetics, 2007. http://www.abmg.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Medical Genetics. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326420662 | Jariya Upadia | Medical Genetics | 1430 Tulane Ave Rm 5562, New Orleans, LA 70112-2632 | 2015-06-23 |
| 1558383570 | Yves Lacassie | Medical Genetics | Children's Hospital - Genetics, 200 Henry Clay Avenue, New Orleans, LA 70118 | 2006-07-25 |
| 1912394925 | Meredith Walker Allain | Medical Genetics | 1319 Jefferson Hwy, New Orleans, LA 70121 | 2015-04-17 |
| 1366618837 | Rapides Healthcare System, LLC | Medical Genetics | 211 4th St, Alexandria, LA 71301-8421 | 2008-05-05 |
| 1699950899 | Dmitriy M. Niyazov | Medical Genetics | 1514 Jefferson Hwy, New Orleans, LA 70121-2429 | 2008-01-07 |
| 1659574739 | Regina Margarita Zambrano | Medical Genetics | 200 Henry Clay Ave, Suite 2308, New Orleans, LA 70118-5720 | 2007-06-07 |
| 1801987664 | Hans Andersson | Medical Genetics | 1415 Tulane Ave, Tulane University Medical School, New Orleans, LA 70112-2600 | 2006-09-27 |
| 1699798603 | Michael Ray Marble | Medical Genetics | Children's Hospital - Genetics, 200 Henry Clay Ave, New Orleans, LA 70118 | 2006-07-25 |
| 1609896562 | Harold Chen | Medical Genetics | 1501 Kings Hwy, Department of Pediatrics, Section of Genetics, Shreveport, LA 71103-4228 | 2006-07-20 |
| 1700803608 | Susonne Annette Ursin | Medical Genetics | 1501 Kings Hwy, Department of Pediatrics, Section of Genetics, Shreveport, LA 71103-4228 | 2006-07-16 |
| Find all providers with the same taxonomy | ||||
| City | BATON ROUGE |
| Zip Code | 70806 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.