Healthcare Provider Details

I. General information

NPI: 1194875625
Provider Name (Legal Business Name): MARK HENRY ZIELINSKI M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/10/2007
Last Update Date: 02/16/2022
Certification Date: 02/16/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5131 ODONOVAN DR STE. 300
BATON ROUGE LA
70808-4782
US

IV. Provider business mailing address

5131 ODONOVAN DR STE. 300
BATON ROUGE LA
70808-4782
US

V. Phone/Fax

Practice location:
  • Phone: 225-374-0400
  • Fax: 225-374-0430
Mailing address:
  • Phone: 225-374-0400
  • Fax: 225-374-0430

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number09052R
License Number StateLA
# 2
Primary TaxonomyN
Taxonomy Code2084P0805X
TaxonomyGeriatric Psychiatry Physician
License Number09052R
License Number StateLA
# 3
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number09052R
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: