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:
Map and Directions

Health care specialties

SpecialtyCodeLicense #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 4 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 1427088079 NPPES
Louisiana MEDICAID 1968579

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