Provider Demographics
NPI:1942477583
Name:MARKER, JOHN DERRICK (MD)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:DERRICK
Last Name:MARKER
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 1:1430 TULANE AVE SL 50
Mailing Address - Street 2:
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70112
Mailing Address - Country:US
Mailing Address - Phone:504-988-7809
Mailing Address - Fax:504-988-3971
Practice Address - Street 1:1430 TULANE AVE SL 50
Practice Address - Street 2:
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70112
Practice Address - Country:US
Practice Address - Phone:504-988-7809
Practice Address - Fax:504-988-3971
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-13
Last Update Date:2017-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
LAMD204045207R00000X
LAMD.204045208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalist
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine