Wofford, Mark Douglas
Wofford, Mark Douglas is an individual health care provider with primary practice located at 8230 Summa Ave Ste C , Baton Rouge LA 70809-3465. He recently has only one registered license in Allopathic & Osteopathic Physicians / Diagnostic Radiology, which is considered as his primary health care specialty. Wofford, Mark Douglas can be contacted via phone (225) 757-0552.Contact Information
Primary practice address
8230 Summa Ave Ste C
Baton Rouge LA 70809-3465
Phone: (225) 757-0552
Fax: (225) 763-9997
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Diagnostic Radiology | 2085R0202X | 12503R | Louisiana |
Profile Details
| NPI number | 1467432286 |
|---|---|
| LBN Legal business name | Wofford, Mark Douglas |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jan 18th, 2006 |
| Last updated | Jan 11th, 2015 - about 11 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 | 1467432286 | NPPES |
| Louisiana | Other | 5H747 | MEDICARE |
| Louisiana | MEDICAID | 1493481 | MEDICARE |
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