Baucum, Ralph Willard

Baucum, Ralph Willard is an individual health care provider with primary practice located at 1453 E Bert Koun Loop Ste 112, Shreveport LA 71105-6800. He recently has only one registered license in Allopathic & Osteopathic Physicians / Cardiovascular Disease, which is considered as his primary health care specialty. Baucum, Ralph Willard can be contacted via phone (318) 222-3695.

Contact Information

Primary practice address
1453 E Bert Koun Loop Ste 112 Shreveport LA 71105-6800
Fax: (318) 424-0717
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Cardiovascular Disease 207RC0000X 019833 Louisiana

Profile Details

NPI number 1295735793
LBN Legal business name Baucum, Ralph Willard
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 26th, 2005
Last updated Jan 30th, 2017 - about 7 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1295735793 NPPES
Louisiana MEDICAID 1996076

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