Provider Demographics
NPI:1417053653
Name:MARKS, HERBERT W (MD)
Entity Type:Individual
Prefix:DR
First Name:HERBERT
Middle Name:W
Last Name:MARKS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:HERBERT
Other - Middle Name:W
Other - Last Name:MARKS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:4228 HOUMA BLVD
Mailing Address - Street 2:SUITE 110
Mailing Address - City:METAIRIE
Mailing Address - State:LA
Mailing Address - Zip Code:70006-3001
Mailing Address - Country:US
Mailing Address - Phone:504-455-3434
Mailing Address - Fax:504-455-5477
Practice Address - Street 1:4228 HOUMA BLVD
Practice Address - Street 2:SUITE 110
Practice Address - City:METAIRIE
Practice Address - State:LA
Practice Address - Zip Code:70006-3000
Practice Address - Country:US
Practice Address - Phone:504-455-3434
Practice Address - Fax:504-455-5477
Is Sole Proprietor?:No
Enumeration Date:2006-09-15
Last Update Date:2011-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA010935174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1119181Medicaid
LA1119181Medicaid
LA53934Medicare PIN