Healthcare Provider Details

I. General information

NPI: 1598757551
Provider Name (Legal Business Name): JOSEPH KEMP TULLIER DPM
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/16/2005
Last Update Date: 03/06/2025
Certification Date: 03/06/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4630 BLUEBONNET BLVD
BATON ROUGE LA
70809-9632
US

IV. Provider business mailing address

4630 BLUEBONNET BLVD
BATON ROUGE LA
70809-9632
US

V. Phone/Fax

Practice location:
  • Phone: 225-295-1027
  • Fax: 225-295-1491
Mailing address:
  • Phone: 225-295-1027
  • Fax: 225-295-1491

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code213E00000X
TaxonomyPodiatrist
License NumberDPMPD0113
License Number StateLA
# 2
Primary TaxonomyY
Taxonomy Code213E00000X
TaxonomyPodiatrist
License NumberPD0113
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: