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NPI Code Detail

MEDICARE: DONALD LAMAR LOUCKS M.D.

MEDICARE: DONALD LAMAR LOUCKS 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
1207R00000XInternal Medicine PhysicianME27009FL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
100000OTHERFLBEECHST/CAPP CARE
200000OTHERFLEVOLUTIONS
3000000OTHERFLUNIVERSAL HEALTH CARE
4MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
537222OTHERFLBCBSFL
6MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
700000OTHERFLNOVANET
800000OTHERFLUNITEDHEALTH CARE
900000OTHERFLCAPITAL HEALTH PLAN
1000000OTHERFLSOUTHCARE

General Provider Information

NPI Number : 1962401968
Entity Type Code : Individual
Provider Name (Legal Business Name) : DONALD LAMAR LOUCKS M.D.
Provider Business Mailing Address
First Line : 1300 MEDICAL DR
Second Line :
City : TALLAHASSEE
State : FL
Zip : 32308-4646
Country : US
Telephone Number : 850-216-0100
Fax Number :
Provider Business Practice Location Address
First Line : 1300 MEDICAL DR
Second Line :
City : TALLAHASSEE
State : FL
Zip : 32308-4646
Country : US
Telephone Number : 850-216-0100
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/20/2005
Last Update Date : 06/07/2012

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