Healthcare Provider Details

I. General information

NPI: 1164357877
Provider Name (Legal Business Name): MR. MARCUS TIMOTHY DOWNS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/15/2026
Last Update Date: 06/15/2026
Certification Date: 06/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

906 C M FAGAN DR STE B3
HAMMOND LA
70403-6056
US

IV. Provider business mailing address

906 C M FAGAN DR STE B3
HAMMOND LA
70403-6056
US

V. Phone/Fax

Practice location:
  • Phone: 985-542-1191
  • Fax:
Mailing address:
  • Phone: 985-542-1191
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3747P1801X
TaxonomyPersonal Care Attendant
License Number006849140
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: