Organization
MARK SHOPTAUGH, JR., M.D., PSYCHIATRY, L.L.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARK CHARLES SHOPTAUGH JR. MD (OWNER)
(225) 928-2468
Entity
Organization
Contact information
Practice address
7865 JEFFERSON HWY STE D, BATON ROUGE, LA 70809-1384
(225) 928-2468
(225) 928-2498
Mailing address
7865 JEFFERSON HWY STE D, BATON ROUGE, LA 70809-1384
(225) 928-2468
(225) 928-2498
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
MD205916
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2107615
MARK SHOPTAUGH JR. MD MEDICAID NUMBER (NOT FOR LLC)
LA
Enumeration date
11/03/2017
Last updated
12/06/2017
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