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Contact Information

DONALD D DIETZE JR, MD
29301 N DIXIE RANCH RD
LACOMBE, LA70445
 Phone: 985-871-4114
 Fax: 985-871-4130
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Neurological Surgery

207T00000X 02 Physician/General Surgery
Indicates primary specialty

NPI Profile & details for DONALD D DIETZE JR · (Male)

NPI # 1316913635
Status Active
Credentials MD
Entity Individual
Enumeration date 02/27/2006
Last updated 10/01/2015 - About 11 years ago
Sole proprietor 1 No
Identifiers
  • LA License # 019033
  • LA Other 5E706 MEDICARE PROVIDER NUMBER
Hospital affiliation(s)
  • SOUTHERN SURGICAL HOSPITAL - (Acute Care)
    1700 W LINDBERG DRIVE
    SLIDELL, LA 70458
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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