MEDICARE: ADAM JAMES DUCOING PT, DPT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2251X0800X	Orthopedic Physical Therapist	09064	LA

General Provider Information

NPI Number	:	1144868480
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ADAM JAMES DUCOING PT, DPT

Provider Business Mailing Address
First Line	:	3300 BEHRMAN PL
Second Line	:
City	:	NEW ORLEANS
State	:	LA
Zip	:	70114-8215
Country	:	US
Telephone Number	:	504-374-0015
Fax Number	:

Provider Business Practice Location Address
First Line	:	3300 BEHRMAN PL
Second Line	:
City	:	NEW ORLEANS
State	:	LA
Zip	:	70114-8215
Country	:	US
Telephone Number	:	504-374-0015
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/17/2019
Last Update Date	:	12/17/2019

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