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General NPI Number Information
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NPI Number | 1225211089
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Entity Type | Organization
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Legal Business Name | MARCO A. RAMOS, M.D. APC
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Dates
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Enumeration Date | 12/14/2007
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Last Update Date | 12/14/2007
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Provider Practice Location Address
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Address Line | 2800 HEARNE AVE
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City | SHREVEPORT
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State | LA
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Zip | 71103-3934
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Country | US
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Telephone | 318-635-2086
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Fax | 888-810-8142
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Provider Business Mailing Address
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Address Line | 2800 HEARNE AVE
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City | SHREVEPORT
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State | LA
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Zip | 71103-3934
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Country | US
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Telephone | 318-635-2086
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Fax | 888-810-8142
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. MARCO A RAMOS
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Credential | M.D.
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Telephone | 318-635-2086
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM2500X
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Taxonomy Name | Medical Specialty Clinic/Center
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License Number | 015523
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License Number State | LA
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