Provider Demographics
NPI:1114945656
Name:MCFARLAND, MAIRUS TALIAFERRO (MD)
Entity Type:Individual
Prefix:
First Name:MAIRUS
Middle Name:TALIAFERRO
Last Name:MCFARLAND
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3331 YOUREE DR
Mailing Address - Street 2:
Mailing Address - City:SHREVEPORT
Mailing Address - State:LA
Mailing Address - Zip Code:71105-2115
Mailing Address - Country:US
Mailing Address - Phone:318-861-1144
Mailing Address - Fax:318-861-3366
Practice Address - Street 1:3331 YOUREE DR
Practice Address - Street 2:
Practice Address - City:SHREVEPORT
Practice Address - State:LA
Practice Address - Zip Code:71105-2115
Practice Address - Country:US
Practice Address - Phone:318-861-1144
Practice Address - Fax:318-861-3366
Is Sole Proprietor?:No
Enumeration Date:2006-07-17
Last Update Date:2019-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA018964207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1388424Medicaid
LA5J334Medicare ID - Type Unspecified
LA1388424Medicaid