Groves, Mack Jay

Groves, Mack Jay is an sole proprietor health care provider with primary practice located at 323 S Tyler St , Covington LA 70433-3037. He recently has 3 registered licenses in different health care specialties including Podiatric Medicine & Surgery Service Providers / Podiatrist, Podiatric Medicine & Surgery Service Providers / Foot Surgery, Podiatric Medicine & Surgery Service Providers / Primary Podiatric Medicine. Podiatric Medicine & Surgery Service Providers / Primary Podiatric Medicine is his primary health care specialty. Groves, Mack Jay can be contacted via phone (985) 867-9605.

Contact Information

Primary practice address
323 S Tyler St Covington LA 70433-3037
Phone: (985) 867-9605
Fax: (985) 867-9001
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Podiatric Medicine & Surgery Service Providers / Podiatrist 213E00000X PD190R Louisiana
Podiatric Medicine & Surgery Service Providers / Foot Surgery 213ES0131X PD190R Louisiana
Podiatric Medicine & Surgery Service Providers / Primary Podiatric Medicine 213EP1101X DPM.190R Louisiana

Profile Details

NPI number 1265460877
LBN Legal business name Groves, Mack Jay
Credentials Doctor of Podiatric Medicine (DPM)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jun 30th, 2006
Last updated Sep 6th, 2019 - 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1265460877 NPPES
Other 1265460877 BLUECROSS

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