Provider Demographics
NPI:1568565661
Name:FOOS, MARCUS JAMES (MD)
Entity Type:Individual
Prefix:DR
First Name:MARCUS
Middle Name:JAMES
Last Name:FOOS
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 1:3530 HOUMA BLVD STE 300
Mailing Address - Street 2:
Mailing Address - City:METAIRIE
Mailing Address - State:LA
Mailing Address - Zip Code:70006-4203
Mailing Address - Country:US
Mailing Address - Phone:504-264-5142
Mailing Address - Fax:504-455-2648
Practice Address - Street 1:3530 HOUMA BLVD STE 300
Practice Address - Street 2:
Practice Address - City:METAIRIE
Practice Address - State:LA
Practice Address - Zip Code:70006-4203
Practice Address - Country:US
Practice Address - Phone:504-264-5142
Practice Address - Fax:504-455-2648
Is Sole Proprietor?:No
Enumeration Date:2006-09-06
Last Update Date:2023-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA068410207R00000X
TXL7725207R00000X
OK26654207R00000X
FLME107747207R00000X
LAMD.025716207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA003127043AMedicaid
SCGA1358Medicaid
SCGA1358Medicaid
I06830Medicare UPIN