Provider Demographics
NPI:1598757551
Name:TULLIER, JOSEPH KEMP (DPM)
Entity Type:Individual
Prefix:
First Name:JOSEPH
Middle Name:KEMP
Last Name:TULLIER
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7373 PERKINS RD
Mailing Address - Street 2:
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70808-4373
Mailing Address - Country:US
Mailing Address - Phone:225-246-9790
Mailing Address - Fax:225-246-9100
Practice Address - Street 1:4860 BLUEBONNET BLVD
Practice Address - Street 2:
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70809-9644
Practice Address - Country:US
Practice Address - Phone:225-295-1027
Practice Address - Fax:225-246-9116
Is Sole Proprietor?:No
Enumeration Date:2005-08-16
Last Update Date:2021-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LADPMPD0113213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA183150OtherCOVENTRY
LA7550395OtherAETNA
LA1130281Medicaid
LA7550395OtherAETNA
LA1130281Medicaid
LA4E478Medicare UPIN