Fukuda, Juan M
Fukuda, Juan M is an individual health care provider with primary practice located at 4600 Ambassador Caffery Pkwy Pediatric Emergency Medicine, Lafayette LA 70508-6902. He recently has 3 registered licenses in different health care specialties including Other Service Providers / Specialist, Allopathic & Osteopathic Physicians / Pediatric Emergency Medicine, Allopathic & Osteopathic Physicians / Pediatrics. Other Service Providers / Specialist is his primary health care specialty. Fukuda, Juan M can be contacted via phone (337) 521-9027.Contact Information
Primary practice address
4600 Ambassador Caffery Pkwy Pediatric Emergency Medicine
Lafayette LA 70508-6902
Phone: (337) 521-9027
Fax: (337) 521-9164
Website:
Health care specialties
Specialty | Code | License # | State |
---|---|---|---|
Other Service Providers / Specialist | 174400000X | 14374R | Louisiana |
Allopathic & Osteopathic Physicians / Pediatric Emergency Medicine | 2080P0204X | 14374R | Louisiana |
Allopathic & Osteopathic Physicians / Pediatrics | 208000000X | 14374R | Louisiana |
Profile Details
NPI number | 1154314904 |
---|---|
LBN Legal business name | Fukuda, Juan M |
Credentials | Doctor of Medicine (MD) |
Entity | Individual |
Sole proprietor 1 | No |
Enumeration date | Aug 26th, 2005 |
Last updated | Feb 4th, 2011 - about 14 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.
Identifiers
State | Type | Number | Issuer |
---|---|---|---|
All States | NPI | 1154314904 | NPPES |
Louisiana | MEDICAID | 1113166 |
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