Provider Demographics
NPI:1740929611
Name:SOILEAU, MARCUS ROY (DPM)
Entity type:Individual
Prefix:
First Name:MARCUS
Middle Name:ROY
Last Name:SOILEAU
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:524 DR MICHAEL DEBAKEY DR
Mailing Address - Street 2:
Mailing Address - City:LAKE CHARLES
Mailing Address - State:LA
Mailing Address - Zip Code:70601-5725
Mailing Address - Country:US
Mailing Address - Phone:337-480-4948
Mailing Address - Fax:337-491-7195
Practice Address - Street 1:524 DR MICHAEL DEBAKEY DR
Practice Address - Street 2:
Practice Address - City:LAKE CHARLES
Practice Address - State:LA
Practice Address - Zip Code:70601-5725
Practice Address - Country:US
Practice Address - Phone:337-480-4948
Practice Address - Fax:337-491-7195
Is Sole Proprietor?:No
Enumeration Date:2022-05-31
Last Update Date:2024-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA337816213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery