Individual
TUCKER S. BLACKLEDGE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1501 KINGS HWY, PEDIATRICS, SHREVEPORT, LA 71103-4228
(318) 626-2274
Mailing address
1 CHILDRENS WAY # 653, LITTLE ROCK, AR 72202-3500
(501) 364-1100
(501) 364-4082
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
E-13312
AR
2080P0207X
Pediatric Hematology & Oncology Physician
E-13312
AR
Other
Enumeration date
03/29/2017
Last updated
08/14/2023
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