MEDICARE: DR. MARK ALLEN FRILOUX 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	207R00000X	Internal Medicine Physician	10691	MS

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

General Provider Information

NPI Number	:	1679562748
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MARK ALLEN FRILOUX MD

Provider Business Mailing Address
First Line	:	2001 AIRPORT RD N
Second Line	:	SUITE 204
City	:	FLOWOOD
State	:	MS
Zip	:	39232-8827
Country	:	US
Telephone Number	:	601-932-3191
Fax Number	:	607-420-4375

Provider Business Practice Location Address
First Line	:	1503 HIGHWAY 45 N
Second Line	:
City	:	COLUMBUS
State	:	MS
Zip	:	39705-2113
Country	:	US
Telephone Number	:	662-328-9623
Fax Number	:	662-327-7477

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

Provider Enumeration Date	:	10/20/2005
Last Update Date	:	10/19/2007

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Directions to “ DR. MARK ALLEN FRILOUX MD” Practice Location

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