| Mark Anthony Portacci, MD | |
|
706 Ross Street, Oak Grove, LA 71263 | |
| (318) 428-3237 | |
| (318) 428-6180 |
| Full Name | Mark Anthony Portacci |
|---|---|
| Gender | Male |
| Speciality | Family Practice |
| Experience | 45 Years |
| Location | 706 Ross Street, Oak Grove, Louisiana |
| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1265500490 | NPI | - | NPPES |
| 1330957 | Medicaid | LA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 0015833 (Louisiana) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Lagniappe Homecare Northern Louisiana | Winnfield, LA | Home health agency |
| Legacy National Hospice, Llc | Natchitoches, LA | Hospice |
| Jackson Parish Hospital | Jonesboro, LA | Hospital |
| Forest Haven Nursing & Rehab Ctr, Llc | Jonesboro, LA | Nursing home |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Louisiana Family Medicine Clinic 1 | 4183889009 | 6 |
| Entity Name | West Carroll Health Systems, Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1386700888 PECOS PAC ID: 5294627774 Enrollment ID: O20040402000229 |
| Entity Name | Louisiana Family Medicine Clinic 1 |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1548538200 PECOS PAC ID: 4183889009 Enrollment ID: O20120627000379 |
| Mailing Address | Practice Location Address |
|---|---|
| Mark Anthony Portacci, MD 706 Ross Street, Oak Grove, LA 71263 Ph: (318) 428-3237 | Mark Anthony Portacci, MD 706 Ross Street, Oak Grove, LA 71263 Ph: (318) 428-3237 |
Christopher Domingue, M.D. Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 708 E Main St, Oak Grove, LA 71263 Phone: 318-428-3200 Fax: 318-428-7896 | |
Eric Arbuckle, D.O. Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 502 Ross St, Oak Grove, LA 71263 Phone: 318-428-2358 Fax: 318-428-2350 | |
Peter F Wisniewski I, D.O. Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 706 Ross St, Oak Grove, LA 71263 Phone: 318-428-3237 Fax: 318-428-1362 | |
Erin Newton, Family Medicine Medicare: Not Enrolled in Medicare Practice Location: 706 Ross St, Oak Grove, LA 71263 Phone: 318-428-6130 | |
Noli Guinigundo, M.D. Family Medicine Medicare: Medicare Enrolled Practice Location: 706 Ross St, Oak Grove, LA 71263 Phone: 318-428-3237 Fax: 318-428-6180 |