Mark C Mouton MD LLC
Internal Medicine in Baker, LA. Organization (NPI-2).
NPI number1760626170
StatusActive
Last updated in NPPESJul 1, 2014
Details
- NPI
- 1760626170
- Entity type
- Organization (NPI-2)
- Legal business name
- Mark C Mouton MD LLC
- Organization subpart
- No
- Enumeration date
- Apr 29, 2009
- Last updated
- Jul 1, 2014
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 207R00000X | Internal Medicine | MD.201233 | LA | Yes |
Practice location
12880 Plank RdBaker, LA 70714-4909
Phone 225-774-7111 · Fax 225-774-7714
Mailing address
12880 Plank RdBaker, LA 70714-4909
Phone 225-774-7111 · Fax 225-774-7714
Authorized official
Mark Christian Mouton
Member
5046213298
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