Individual
DR. MARK P. VIGEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PH.D.
Contact information
Practice address
3341 YOUREE DR STE 20A, SHREVEPORT, LA 71105-2149
(318) 425-2000
(318) 424-2601
Mailing address
3341 YOUREE DR STE 20A, SHREVEPORT, LA 71105-2149
(318) 425-2000
(318) 424-2601
Taxonomy
Speciality
Code
Description
License number
State
103TF0200X
Forensic Psychologist
Primary
280
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
009755
VALUE OPTIONS
LA
01
—
20559
BLUE CROSS/BLUE SHIELD
LA
Enumeration date
03/09/2006
Last updated
01/08/2020
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