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Individual

DR. JOHN J JUCAS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
JOHN J. JUCAS M.D., 6121 FERN AVE UNIT 107, SHREVEPORT, LA 71105
(318) 617-3667
(870) 863-5242
Mailing address
JOHN J. JUCAS M.D., 6121 FERN AVE UNIT 107, SHREVEPORT, LA 71105
(318) 617-3667
(870) 863-5242

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
C4839
AR
207N00000X
Dermatology Physician
Primary
MD.206362
LA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
106151001
AR
01
14299000000
QUALCHOICE
AR
05
1911194
LA
01
24614
BLUECROSS BLUESHIELD
LA
01
52777
BLUECROSS BLUESHIELD
AR
01
710543368
TRICARE
AR
Enumeration date
08/18/2006
Last updated
06/03/2024
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