Provider Demographics
NPI:1902999485
Name:LUPO, JOSEPH PETER (MD)
Entity Type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:PETER
Last Name:LUPO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Mailing Address - Street 1:900 E SAINT MARY BLVD STE 104
Mailing Address - Street 2:
Mailing Address - City:LAFAYETTE
Mailing Address - State:LA
Mailing Address - Zip Code:70503-2378
Mailing Address - Country:US
Mailing Address - Phone:337-504-3640
Mailing Address - Fax:337-504-3776
Practice Address - Street 1:900 E SAINT MARY BLVD STE 104
Practice Address - Street 2:
Practice Address - City:LAFAYETTE
Practice Address - State:LA
Practice Address - Zip Code:70503-2378
Practice Address - Country:US
Practice Address - Phone:337-504-3640
Practice Address - Fax:337-504-3776
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-02
Last Update Date:2021-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAMD.204786208600000X, 2086S0122X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0122XAllopathic & Osteopathic PhysiciansSurgeryPlastic and Reconstructive Surgery
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery