Mainous, Mark Richard
Mainous, Mark Richard is an individual health care provider with primary practice located at 8001 Youree Dr Suite 840, Shreveport LA 71115-2302. He recently has only one registered license in Allopathic & Osteopathic Physicians / Surgical Critical Care, which is considered as his primary health care specialty. Mainous, Mark Richard can be contacted via phone (318) 212-2846.Contact Information
Primary practice address
8001 Youree Dr Suite 840
Shreveport LA 71115-2302
Phone: (318) 212-2846
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Surgical Critical Care | 2086S0102X | 07555R | Louisiana |
Profile Details
| NPI number | 1427088079 |
|---|---|
| LBN Legal business name | Mainous, Mark Richard |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jul 3rd, 2006 |
| Last updated | Jul 8th, 2021 - about 5 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 | 1427088079 | NPPES |
| Louisiana | MEDICAID | 1968579 |
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