Individual
DONALD LAMAR LOUCKS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1300 MEDICAL DR, TALLAHASSEE, FL 32308-4646
(850) 216-0100
Mailing address
1300 MEDICAL DR, TALLAHASSEE, FL 32308-4646
(850) 216-0100
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
ME27009
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00000
BEECHST/CAPP CARE
FL
01
—
000000
UNIVERSAL HEALTH CARE
FL
05
—
00134945A
—
GA
05
—
057262400
—
FL
01
—
37222
BCBSFL
FL
Enumeration date
07/20/2005
Last updated
06/07/2012
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