Individual
MR. MARK FREDERICK BROWN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2508 BERT KOUNS INDUSTRIAL LOOP STE 310, SHREVEPORT, LA 71118-3154
(318) 212-5880
(318) 212-5885
Mailing address
939 DELAWARE ST, SHREVEPORT, LA 71106
(318) 681-6174
(318) 681-7695
Taxonomy
Speciality
Code
Description
License number
State
2086S0120X
Pediatric Surgery Physician
018087
LA
2086S0120X
Pediatric Surgery Physician
Primary
MD.018087
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1971961
—
LA
Enumeration date
07/11/2005
Last updated
06/21/2021
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