Individual
JULIE A CUPP
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
7843 YOUREE DR, SHREVEPORT, LA 71105-5505
(318) 212-3772
(318) 212-3773
Mailing address
7843 YOUREE DR, SHREVEPORT, LA 71105-5505
(318) 212-3772
(318) 212-3773
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
R7857
IA
2086X0206X
Surgical Oncology Physician
2014-00152
NC
2086X0206X
Surgical Oncology Physician
Primary
303750
LA
2086X0206X
Surgical Oncology Physician
P6366
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
329507301
—
TX
Enumeration date
05/22/2007
Last updated
06/23/2021
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