Landry, Mark J

Landry, Mark J is an individual health care provider with primary practice located at 3621 Ambassador Caffery Pkwy Ste 100 , Lafayette LA 70503-5132. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Emergency Medicine, Physician Assistants & Advanced Practice Nursing Providers / Family. Physician Assistants & Advanced Practice Nursing Providers / Family is his primary health care specialty. Landry, Mark J can be contacted via phone (337) 534-4410.

Contact Information

Primary practice address
3621 Ambassador Caffery Pkwy Ste 100 Lafayette LA 70503-5132
Phone: (337) 534-4410
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Emergency Medicine 207P00000X RN095042 Louisiana
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X AP04519 Louisiana

Profile Details

NPI number 1679518823
LBN Legal business name Landry, Mark J
Credentials Nurse Practitioner (NP)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 19th, 2006
Last updated Feb 17th, 2023 - about 2 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 1679518823 NPPES
Louisiana MEDICAID 1467430

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