MEDICARE: MR. JOSEPH MARK BILLIOT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251K00000X	Public Health or Welfare Agency

General Provider Information

NPI Number	:	1396431979
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. JOSEPH MARK BILLIOT

Provider Business Mailing Address
First Line	:	2036 ALLISON ST
Second Line	:
City	:	MORGAN CITY
State	:	LA
Zip	:	70380-2256
Country	:	US
Telephone Number	:	985-385-4036
Fax Number	:	985-385-4048

Provider Business Practice Location Address
First Line	:	2036 ALLISON ST
Second Line	:
City	:	MORGAN CITY
State	:	LA
Zip	:	70380-2256
Country	:	US
Telephone Number	:	985-385-4036
Fax Number	:	985-385-4048

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/17/2023
Last Update Date	:	04/17/2023

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