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General NPI Number Information
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NPI Number | 1922004381
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Entity Type | Individual
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Provider Name | JERRY ELBERT TOUPS JR. D.P.M
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Gender | Male
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Dates
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Enumeration Date | 06/21/2005
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Last Update Date | 06/17/2025
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Provider Practice Location Address
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Address Line | 1449 E BERT KOUNS
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City | SHREVEPORT
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State | LA
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Zip | 71105-5663
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Country | US
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Telephone | 318-681-4282
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Fax |
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Provider Business Mailing Address
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Address Line | 7821 YOUREE DR
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City | SHREVEPORT
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State | LA
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Zip | 71105-5505
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Country | US
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Telephone | 318-213-3668
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Fax | 318-213-3670
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 213E00000X
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Taxonomy Name | Podiatrist
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License Number | PD0100
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License Number State | LA
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Taxonomy #2
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Taxonomy Code | 213E00000X
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Taxonomy Name | Podiatrist
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License Number | DPM.PD0100
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License Number State | LA
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