Individual
DR. MARK ALLEN CIMINO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1111 HOMER RD, MINDEN, LA 71055-3027
(318) 377-7500
(318) 377-2324
Mailing address
1111 HOMER RD, MINDEN, LA 71055-3027
(318) 377-7500
(318) 377-2324
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
E3519
AR
207Q00000X
Family Medicine Physician
Primary
15018R
LA
207Q00000X
Family Medicine Physician
E3519
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
030637
LA NARCOTIC LICENSE
LA
05
—
1422878
—
AR
05
—
1422878
—
LA
01
—
LA15018R
STATE MEDICAL LICENSE
LA
Enumeration date
08/12/2005
Last updated
03/07/2023
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