Healthcare Provider Details

I. General information

NPI: 1568565661
Provider Name (Legal Business Name): MARCUS JAMES FOOS MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/06/2006
Last Update Date: 05/02/2023
Certification Date: 05/02/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3530 HOUMA BLVD STE 300
METAIRIE LA
70006-4203
US

IV. Provider business mailing address

3530 HOUMA BLVD STE 300
METAIRIE LA
70006-4203
US

V. Phone/Fax

Practice location:
  • Phone: 504-264-5142
  • Fax: 504-455-2648
Mailing address:
  • Phone: 504-264-5142
  • Fax: 504-455-2648

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number068410
License Number StateGA
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberL7725
License Number StateTX
# 3
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number26654
License Number StateOK
# 4
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberME107747
License Number StateFL
# 5
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberMD.025716
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: