Individual
DR. ROY VANCE MARKHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2400 HOSPITAL DR, SUITE 490, BOSSIER CITY, LA 71111-2385
(318) 798-9400
(318) 798-6785
Mailing address
PO BOX 51008, SHREVEPORT, LA 71135-1008
(318) 798-9400
(318) 798-6785
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
MD.05815R
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
060041371
RAILROAD MEDICARE
LA
05
—
107412201
—
TX
05
—
108411001
—
AR
05
—
1323195
—
LA
Enumeration date
10/25/2005
Last updated
07/08/2010
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