Provider Demographics
NPI:1851331458
Name:CULOTTA, ROY JOSEPH (MD)
Entity Type:Individual
Prefix:DR
First Name:ROY
Middle Name:JOSEPH
Last Name:CULOTTA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 919237
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75391-9237
Mailing Address - Country:US
Mailing Address - Phone:225-381-2755
Mailing Address - Fax:225-381-2759
Practice Address - Street 1:8585 PICARDY AVE
Practice Address - Street 2:SUITE 313
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70809
Practice Address - Country:US
Practice Address - Phone:225-381-2755
Practice Address - Fax:225-381-2755
Is Sole Proprietor?:No
Enumeration Date:2006-06-08
Last Update Date:2024-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAMD.14171R207RC0200X, 207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
No207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1105724Medicaid
4A520DD21Medicare PIN