Chad M Domangue, MD
Pain Medicine, Interventional Pain Medicine in Covington, LA. Individual provider (NPI-1).
NPI number1629286646
StatusActive
Last updated in NPPESMar 5, 2015
Details
- NPI
- 1629286646
- Entity type
- Individual (NPI-1)
- Name
- Chad M Domangue
- Credential
- MD
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- May 21, 2007
- Last updated
- Mar 5, 2015
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 208VP0014X | Pain Medicine, Interventional Pain Medicine | 202018 | LA | Yes |
| 2084N0400X | Psychiatry & Neurology, Neurology | TP-366 | KY |
Practice location
76 Starbrush CirCovington, LA 70433-7208
Phone 985-801-0581
Mailing address
76 Starbrush CirCovington, LA 70433-7208
Phone 985-801-0581
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