Individual
TUCKER L MADDEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
79630 HWY 21, BUSH, LA 70431
(985) 730-2252
(985) 730-2258
Mailing address
5959 S SHERWOOD FOREST BLVD, BATON ROUGE, LA 70816-6038
(985) 730-2252
(225) 765-9196
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
327893
LA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2524828
—
LA
Enumeration date
03/31/2020
Last updated
03/23/2023
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