Individual
DR. MARK CHRISTIAN MOUTON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
12880 PLANK RD, BAKER, LA 70714-4909
(225) 774-7111
(225) 774-7111
Mailing address
12880 PLANK RD, BAKER, LA 70714-4909
(225) 774-7111
(225) 774-7714
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
MD.201233
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1090484
—
LA
Enumeration date
08/07/2007
Last updated
06/29/2014
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