Provider Demographics
NPI:1417900416
Name:KARMAKAR, MILON G (MD)
Entity Type:Individual
Prefix:
First Name:MILON
Middle Name:G
Last Name:KARMAKAR
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 1:3300 ALBERT L BICKNELL DR
Mailing Address - Street 2:SUITE 6
Mailing Address - City:SHREVEPORT
Mailing Address - State:LA
Mailing Address - Zip Code:71103-3903
Mailing Address - Country:US
Mailing Address - Phone:318-636-5724
Mailing Address - Fax:318-636-5728
Practice Address - Street 1:3300 ALBERT L BICKNELL DR
Practice Address - Street 2:SUITE 6
Practice Address - City:SHREVEPORT
Practice Address - State:LA
Practice Address - Zip Code:71103-3903
Practice Address - Country:US
Practice Address - Phone:318-636-5724
Practice Address - Fax:318-636-5728
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA13369R208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1567566Medicaid
LA1567566Medicaid
LA5H152Medicare ID - Type Unspecified