Individual
DR. JOSEPH R TERRACINA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D. P.A.
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
12546
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0111878
—
MS
01
—
123945001
MEDICAID PROVIDER NUMBER
AR
01
—
1981966
LOUISIANA MEDICAID NUMBER
MS
01
—
96649
AR BCBS PROVIDER NUMBER
AR
Enumeration date
04/03/2006
Last updated
12/17/2009
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