Organization
DARYL S. MARX M.D., L.L.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DARYL S. MARX M.D. (OWNER)
(318) 398-9709
Entity
Organization
Contact information
Practice address
3418 MEDICAL PARK DR, SUITE 1, MONROE, LA 71203-2376
(318) 398-9709
(318) 398-9711
Mailing address
3418 MEDICAL PARK DR, SUITE 1, MONROE, LA 71203-2376
(318) 398-9709
(318) 398-9711
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
MD.024323
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1063462695
INDIVIDUAL NPI
—
05
—
1570192
—
LA
01
—
4379459970
BLUE CROSS BLUE SHIELD
LA
Enumeration date
02/19/2008
Last updated
02/19/2008
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