Provider Demographics
NPI:1710924147
Name:MARKSVILLE HOSPITALIST PHYSICIANS, INC
Entity Type:Organization
Organization Name:MARKSVILLE HOSPITALIST PHYSICIANS, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:RON
Authorized Official - Middle Name:
Authorized Official - Last Name:WEISS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:972-934-3200
Mailing Address - Street 1:17304 PRESTON RD
Mailing Address - Street 2:SUITE 555
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75252-5618
Mailing Address - Country:US
Mailing Address - Phone:972-934-3200
Mailing Address - Fax:
Practice Address - Street 1:4231 HIGHWAY 1192
Practice Address - Street 2:
Practice Address - City:MARKSVILLE
Practice Address - State:LA
Practice Address - Zip Code:71351-4711
Practice Address - Country:US
Practice Address - Phone:318-253-8611
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-02
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1449326Medicaid
LA1900H1530ZOtherBC/BS
LA5CQ18Medicare ID - Type Unspecified