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Individual

MARK C CALLANAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
7925 YOUREE DR STE 200, SHREVEPORT, LA 71105
(318) 212-3610
(318) 212-3709
Mailing address
7925 YOUREE DR STE 200, SHREVEPORT, LA 71105-5134
(318) 212-3610
(318) 212-3709

Taxonomy

Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
320551
LA
207X00000X
Orthopaedic Surgery Physician
L-255690
MA

Other

Enumeration date
05/14/2013
Last updated
06/21/2021
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