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Contact Information

TUCKER S BLACKLEDGE, MD
1501 KINGS HWY
PEDIATRICS
SHREVEPORT, LA71103-4228
 Phone: 318-626-2274
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Pediatrics

208000000X 37 Physician/Pediatric Medicine
 

Pediatric Hematology-Oncology

2080P0207X 37 Physician/Pediatric Medicine
Indicates primary specialty

NPI Profile & details for TUCKER S BLACKLEDGE · (Male)

NPI Number 1134651284
Status Active
Credentials MD
Entity Individual
Enumeration date 03/29/2017
Last updated 08/14/2023 - About 3 years ago
Sole proprietor 1 No
Identifiers
  • AR License # E-13312
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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