| Mark C Mouton Md Llc | |
|
12880 Plank Rd Baker LA 70714-4909 | |
| (225) 774-7111 | |
| (225) 774-7714 |
| Full Name | Mark C Mouton Md Llc |
|---|---|
| Speciality | Internal Medicine |
| Location | 12880 Plank Rd, Baker, Louisiana |
| Authorized Official Name and Position | Mark Christian Mouton (MEMBER) |
| Authorized Official Contact | 5046213298 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Mark C Mouton Md Llc 12880 Plank Rd Baker LA 70714-4909 Ph: (225) 774-7111 | Mark C Mouton Md Llc 12880 Plank Rd Baker LA 70714-4909 Ph: (225) 774-7111 |
| NPI Number | 1760626170 |
|---|---|
| Provider Enumeration Date | 04/29/2009 |
| Last Update Date | 07/01/2014 |
| Medicare PECOS PAC ID | 5597816207 |
|---|---|
| Medicare Enrollment ID | O20090619000095 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1760626170 | NPI | - | NPPES |
| 1090484 | Medicaid | LA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | MD.201233 (Louisiana) | Primary |
| Provider Name | Mark C Mouton |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1164613758 PECOS PAC ID: 8426119736 Enrollment ID: I20081204000975 |
| Provider Name | Stephanie Linton Nolan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1912262429 PECOS PAC ID: 7517267925 Enrollment ID: I20151207002161 |
| Provider Name | Dorothy A Ewen |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1639562515 PECOS PAC ID: 4880994219 Enrollment ID: I20151207003032 |
| Provider Name | Elizabeth Ann Mouton |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1760905343 PECOS PAC ID: 9739449398 Enrollment ID: I20180131000857 |
| Provider Name | Lauri Garrett |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1063082279 PECOS PAC ID: 7517362163 Enrollment ID: I20210820000927 |
| Provider Name | Kimberly Groht Watson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1992461461 PECOS PAC ID: 4789077892 Enrollment ID: I20220214002242 |
Premier Wellness Associates, Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 4444 Groom Rd, Baker, LA 70714 Phone: 225-774-9134 Fax: 225-774-9136 | |
Unique Healthcare Options Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 5120 Groom Rd, Baker, LA 70714 Phone: 225-774-1077 Fax: 225-774-1078 | |
Ernest Gene Thompson Jr Md Apmc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 12902 Plank Rd, Baker, LA 70714 Phone: 225-774-3883 Fax: 225-774-7777 | |
Mercy Primary Care Home Visits Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 8519 Pettit Rd, Baker, LA 70714 Phone: 225-200-3216 | |
South Louisiana Primary Care Llc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 12902 Plank Rd, Baker, LA 70714 Phone: 225-218-4816 Fax: 225-302-5057 | |
Mcms, Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 17625 Wisdom Dr, Baker, LA 70714 Phone: 225-505-5217 Fax: 225-658-0099 |