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General NPI Number Information
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NPI Number | 1376860148
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Entity Type | Individual
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Provider Name | MARK TYSON GARON MD
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Gender | Male
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Dates
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Enumeration Date | 05/03/2010
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Last Update Date | 07/16/2024
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Provider Practice Location Address
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Address Line | 10310 THE GROVE BLVD
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City | BATON ROUGE
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State | LA
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Zip | 70836-6455
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Country | US
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Telephone | 225-761-5200
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Fax | 225-766-1499
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Provider Business Mailing Address
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Address Line | 1514 JEFFERSON HWY
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City | NEW ORLEANS
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State | LA
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Zip | 70121-2429
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Country | US
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Telephone | 504-842-4000
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number | 301449
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License Number State | LA
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Taxonomy #2
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Taxonomy Code | 2086S0105X
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Taxonomy Name | Surgery of the Hand (Surgery) Physician
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License Number | 301449
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License Number State | LA
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Taxonomy #3
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Taxonomy Code | 207XS0106X
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Taxonomy Name | Orthopaedic Hand Surgery Physician
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License Number | 301449
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License Number State | LA
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