Individual
BRIAN JOSEPH MARINO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
604 N ACADIA RD, SUITE 207, THIBODAUX, LA 70301-4897
(985) 446-1763
(985) 446-9813
Mailing address
604 N ACADIA RD, SUITE 207, THIBODAUX, LA 70301-4897
(985) 446-1763
(985) 446-9813
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
200188
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1647519
—
LA
Enumeration date
10/12/2005
Last updated
04/10/2012
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