Provider Demographics
NPI:1275984510
Name:SOILEAU, MARK CHADWICK JR (MD)
Entity Type:Individual
Prefix:DR
First Name:MARK
Middle Name:CHADWICK
Last Name:SOILEAU
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 1079
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:LA
Mailing Address - Zip Code:71418-1079
Mailing Address - Country:US
Mailing Address - Phone:337-831-3769
Mailing Address - Fax:
Practice Address - Street 1:7939 HIGHWAY 165
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:LA
Practice Address - Zip Code:71418-3327
Practice Address - Country:US
Practice Address - Phone:318-649-6106
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-06-28
Last Update Date:2022-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA329558207R00000X, 207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine