Individual
MR. MARC THOMAS HEBERT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
PA200015
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1812994
—
LA
01
—
5D847P624
MEDICARE LEGACY NUMBER
LA
01
—
P02589614
RAILROAD MEDICARE
LA
Enumeration date
07/27/2006
Last updated
01/25/2021
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