Provider Demographics
NPI:1598757551
Name:TULLIER, JOSEPH KEMP (DPM)
Entity type:Individual
Prefix:
First Name:JOSEPH
Middle Name:KEMP
Last Name:TULLIER
Suffix:
Gender:
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4630 BLUEBONNET BLVD
Mailing Address - Street 2:
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70809-9632
Mailing Address - Country:US
Mailing Address - Phone:225-295-1027
Mailing Address - Fax:225-295-1491
Practice Address - Street 1:4630 BLUEBONNET BLVD
Practice Address - Street 2:
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70809-9632
Practice Address - Country:US
Practice Address - Phone:225-295-1027
Practice Address - Fax:225-295-1491
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-16
Last Update Date:2025-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LADPMPD0113213E00000X
LAPD0113213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA183150OtherCOVENTRY
LA1130281Medicaid
LA7550395OtherAETNA
LA7550395OtherAETNA
LA1130281Medicaid
LA4E478Medicare UPIN