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1497813224

NPI Code Detail

MEDICARE: JOHN MARK JANES MD

MEDICARE: JOHN MARK JANES MD

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	2084P0800X	Psychiatry Physician	H8939	TX
2	2084P0804X	Child & Adolescent Psychiatry Physician	H8939	TX

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	260038562	OTHER	TX	RAILROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	82W960	OTHER	TX	BLUE CROSS BLUE SHIELD

General Provider Information

NPI Number	:	1497813224
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOHN MARK JANES MD

Provider Business Mailing Address
First Line	:	2001 S MEDFORD DR
Second Line	:
City	:	LUFKIN
State	:	TX
Zip	:	75901-6260
Country	:	US
Telephone Number	:	936-633-5676
Fax Number	:

Provider Business Practice Location Address
First Line	:	2001 S MEDFORD DR
Second Line	:
City	:	LUFKIN
State	:	TX
Zip	:	75901-6260
Country	:	US
Telephone Number	:	936-633-5676
Fax Number	:

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

Provider Enumeration Date	:	12/05/2006
Last Update Date	:	01/31/2014

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Directions to “ JOHN MARK JANES MD” Practice Location

Language	Start Address	Practice Location

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