Provider Demographics
NPI:1558425033
Name:DELUCCA, JOSEPH ANTHONY (DPM)
Entity Type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:ANTHONY
Last Name:DELUCCA
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:3101 RIDGELAKE DR
Mailing Address - Street 2:
Mailing Address - City:METAIRIE
Mailing Address - State:LA
Mailing Address - Zip Code:70002-4926
Mailing Address - Country:US
Mailing Address - Phone:504-831-2671
Mailing Address - Fax:504-831-2646
Practice Address - Street 1:3101 RIDGELAKE DR
Practice Address - Street 2:
Practice Address - City:METAIRIE
Practice Address - State:LA
Practice Address - Zip Code:70002-4926
Practice Address - Country:US
Practice Address - Phone:504-831-2671
Practice Address - Fax:504-831-2646
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-20
Last Update Date:2011-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LADPM.PD025R213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1324001Medicaid
LA03979OtherBLUE CROSS
LA826480248OtherRAILROAD MEDICARE
LA826480248OtherRAILROAD MEDICARE
LAT11310Medicare UPIN