John R. Tucker III, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

10080R Issued in LA

Practice address

433 Plaza St
Bogalusa, LA 70427-3729

Phone

(985) 730-6705

Fax

(985) 730-7183

NPI assigned

Jul 19, 2006

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1153267200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1578583100",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 MEMPHIS ST",
            "city": "BOGALUSA",
            "state": "LA",
            "postal_code": "704273862",
            "telephone_number": "985-730-6705",
            "fax_number": "985-730-6709"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "433 PLAZA ST",
            "city": "BOGALUSA",
            "state": "LA",
            "postal_code": "704273729",
            "telephone_number": "985-730-6705",
            "fax_number": "985-730-7183"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TUCKER",
        "first_name": "JOHN",
        "middle_name": "R.",
        "name_suffix": "III",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-19",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "LA",
            "license": "10080R",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1985449",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Hendria Thompson, CSW
• Alison Leigh Thornhill, NP
• Miyoko Tiner, N/A
• Tony Travis, PT
• Cynthia Marie Trudell, R.PH.
• Quovatas Turner, RSW
• Janamarie Oriola Uy, M.D.
• Joshua Paul Vallelungo
• Mallory Knight Varnado, MD
• Vcphcs V, LLC

• Family Medicine Physician in Bogalusa, LA
• Providers in Bogalusa, LA by specialty
• Family Medicine Physician in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.