Individual
DR. MARK A BANKS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1120 15TH ST, BIW-2144, AUGUSTA, GA 30912-0004
(706) 721-4544
(706) 721-7753
Mailing address
1945 E 70TH ST, SUITE B, SHREVEPORT, LA 71105-5347
(318) 797-1743
(706) 721-7599
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
072858
GA
207L00000X
Anesthesiology Physician
Primary
301220
LA
207L00000X
Anesthesiology Physician
72858
GA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
06/29/2010
Last updated
09/02/2016
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