MEDICARE: DR. JOHN DAVID COUK M.D.

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	207P00000X	Emergency Medicine Physician	09212R	LA
2	207P00000X	Emergency Medicine Physician	4301066565	MI

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1740281930
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JOHN DAVID COUK M.D.

Provider Business Mailing Address
First Line	:	PO BOX 740550
Second Line	:
City	:	NEW ORLEANS
State	:	LA
Zip	:	70174-0550
Country	:	US
Telephone Number	:	504-366-7638
Fax Number	:

Provider Business Practice Location Address
First Line	:	2021 PERDIDO ST
Second Line	:
City	:	NEW ORLEANS
State	:	LA
Zip	:	70112-1352
Country	:	US
Telephone Number	:	504-903-3144
Fax Number	:

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

Provider Enumeration Date	:	08/10/2005
Last Update Date	:	07/08/2007

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Directions to “ DR. JOHN DAVID COUK M.D.” Practice Location

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