Individual
DR. MARK LEWIS KANTROW
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
7777 HENNESSY BLVD STE 501B, BATON ROUGE, LA 70808-4300
(225) 765-1737
(225) 765-1842
Mailing address
5959 S SHERWOOD FOREST BLVD, BATON ROUGE, LA 70816-6038
(225) 765-1737
(225) 765-9196
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
09411R
LA
207RH0002X
Hospice and Palliative Medicine (Internal Medicine) Physician
Primary
09411R
LA
208M00000X
Hospitalist Physician
09411R
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00621757
—
MS
05
—
1962783
—
LA
01
—
P00020218
RAIL ROAD MEDICARE
LA
Enumeration date
08/02/2005
Last updated
05/26/2025
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