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Contact Information

KELLY M FUQUA, MD
920 1ST AVE
SULPHUR, LA70663-3425
 Phone: 337-527-7034
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Family Medicine

207Q00000X 08 Physician/Family Practice
Indicates primary specialty

NPI Profile & details for KELLY M FUQUA · (Female)

NPI Number 1861667297
Status Active
Credentials MD
Entity Individual
Enumeration date 04/27/2008
Last updated 10/13/2012 - About 14 years ago
Sole proprietor 1 No
Identifiers
  • LA License # 200962
  • LA Medicaid 1072907
Hospital affiliation(s)
  • CHRISTUS ST PATRICK HOSPITAL - (Acute Care)
    524 DR MICHAEL DEBAKEY STREET
    LAKE CHARLES, LA 70601
  • WEST CALCASIEU CAMERON HOSPITAL - (Acute Care)
    701 EAST CYPRESS STREET
    SULPHUR, LA 70663
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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