Active NPI
Ludovic Azafack Tsague, PHARMD
- Pharmacist
- Fort Stewart, GA
National Provider Identifier
1053910679
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 27641
- Practice address
- 1061 Harmon Ave
Fort Stewart, GA 31314-5641 - Phone
- (912) 435-5435
- NPI assigned
- Oct 23, 2020
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 27641 | MD | Primary |
Addresses
Primary practice location
1061 Harmon Ave
Fort Stewart, GA 31314-5641
Mailing address
1061 Harmon Ave
Fort Stewart, GA 31314-5641
Phone (912) 435-5435
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| NA | Other | NA |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Other URL | NA | Other |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 27641 | MD | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1603411200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1707350400000",
"number": "1053910679",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1061 HARMON AVE",
"city": "FORT STEWART",
"state": "GA",
"postal_code": "313145641",
"telephone_number": "912-435-5435"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1061 HARMON AVE",
"city": "FORT STEWART",
"state": "GA",
"postal_code": "313145641",
"telephone_number": "912-435-5435"
}
],
"practiceLocations": [],
"basic": {
"last_name": "AZAFACK TSAGUE",
"first_name": "LUDOVIC",
"name_prefix": "Dr.",
"credential": "PHARMD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2020-10-23",
"last_updated": "2024-02-08",
"certification_date": "2024-02-08",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "MD",
"license": "27641",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NA",
"identifier": "NA",
"state": null
}
],
"endpoints": [
{
"endpointType": "OTHERS",
"endpointTypeDescription": "Other URL",
"endpoint": "NA",
"affiliation": "N",
"endpointDescription": "NA",
"use": "OTHER",
"useDescription": "Other",
"useOtherDescription": "NA",
"contentType": "OTHER",
"contentTypeDescription": "Other",
"contentOtherDescription": "NA",
"address_1": "8601 Martin Luther King Jr Hwy",
"city": "Lanham",
"state": "MD",
"country_code": "US",
"postal_code": "207061500",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Fort Stewart, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 8, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.