Domangue, Lee Robert

Domangue, Lee Robert is an individual health care provider with primary practice located at 100 Medical Center Drive , Slidell LA 70461-5520. He recently has only one registered license in Allopathic & Osteopathic Physicians / Emergency Medicine, which is considered as his primary health care specialty. Domangue, Lee Robert can be contacted via phone (985) 646-5189.

Contact Information

Primary practice address
100 Medical Center Drive Slidell LA 70461-5520
Phone: (985) 646-5189
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Emergency Medicine 207P00000X 013775 Louisiana
Allopathic & Osteopathic Physicians / Emergency Medicine 207P00000X MD.013775 Louisiana

Profile Details

NPI number 1457308850
LBN Legal business name Domangue, Lee Robert
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date May 30th, 2006
Last updated Oct 3rd, 2011 - about 15 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1457308850 NPPES
Louisiana MEDICAID 1195529
Louisiana MEDICAID 04888790

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