MARK DOUGLAS PORTA JR. (NPI# 1275890436) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1275890436 |
| Entity Type | Individual |
| Full Name | MARK DOUGLAS PORTA JR. |
| Practice Address |
1501 Kings Hwy Lsuhsc Dept. of Gastroenterology Shreveport LA 71130 |
| Practice Telephone | 3188132502 |
| Mailing Telephone | 3188132502 |
| Enumeration Date | 2012-04-12 |
| Last Update Date | 2015-07-30 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207R00000X | Internal Medicine | 206897 | LA | Allopathic & Osteopathic Physicians |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982724431 | Mark Douglas Porta Sr. | Dentist | 9533 Fenway Ave, Baton Rouge, LA 70809-1411 | 2007-03-29 |
| Street Address |
1501 KINGS HWY LSUHSC DEPT. OF GASTROENTEROLOGY |
| City | SHREVEPORT |
| State | LA |
| Zip Code | 71130 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801890769 | F Dean Griffen | Surgery | 1501 Kings Hwy, Shreveport, LA 71103-4228 | 2005-06-09 |
| 1336747625 | Lana Nasief | Student in an Organized Health Care Education/Training Program | 1501 Kings Hwy, Shreveport, LA 71103-4228 | 2020-10-09 |
| 1558968834 | Dinesh Regalla | Student in an Organized Health Care Education/Training Program | 1501 Kings Hwy, Shreveport, LA 71103-4228 | 2020-10-08 |
| 1588261283 | Divleen Sidhu | Student in an Organized Health Care Education/Training Program | 1501 Kings Hwy, Shreveport, LA 71103-4228 | 2020-10-06 |
| 1023624517 | Grace Hoffman | Pharmacist | 1501 Kings Hwy, Shreveport, LA 71103-4228 | 2020-09-20 |
| 1194330761 | Yousef Hasan | Student in an Organized Health Care Education/Training Program | 1501 Kings Hwy, Shreveport, LA 71103-4228 | 2020-09-10 |
| 1790399277 | Ricardo Murguia Fuentes | Student in an Organized Health Care Education/Training Program | 1501 Kings Hwy, Shreveport, LA 71103-4228 | 2020-09-02 |
| 1013521509 | Tahir Ahmad | Student in an Organized Health Care Education/Training Program | 1501 Kings Hwy, Shreveport, LA 71103-4228 | 2020-09-02 |
| 1376155309 | Ayesha Malik | Student in an Organized Health Care Education/Training Program | 1501 Kings Hwy, Shreveport, LA 71103-4228 | 2020-08-20 |
| 1104438324 | Elleny Gutierrez | Student in an Organized Health Care Education/Training Program | 1501 Kings Hwy, Shreveport, LA 71103 | 2020-08-19 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003444316 | Aya Mouhaffel | Student in an Organized Health Care Education/Training Program | 1501 King Hwy, Anesethesiology, Shreveport, LA 71130 | 2020-03-31 |
| 1689144461 | John W Ratliff | Student in an Organized Health Care Education/Training Program | Ochsner, 1501, Shreveport, LA 71130 | 2018-12-05 |
| 1790284016 | Alex Michael Fuselier | Student in an Organized Health Care Education/Training Program | Urology, 1501 Kings Highway, Shreveport, LA 71130 | 2018-02-02 |
| 1043839962 | Sarah Mccann Mcneil | Student in an Organized Health Care Education/Training Program | 1501 Kings Highway, Pediatrics, Shreveport, LA 71130 | 2020-04-10 |
| 1659900058 | Eunice Adu Dapaah | Student in an Organized Health Care Education/Training Program | 1501 Kings Highway, Internal Medicine, Shreveport, LA 71130 | 2020-04-07 |
| 1750919106 | Christine Shaw | Student in an Organized Health Care Education/Training Program | 1501 Kings Highway, Emergency Medicine, Shreveport, LA 71130 | 2020-03-31 |
| 1699303966 | Caitlin Hester Laird | Student in an Organized Health Care Education/Training Program | 1501 Kings Highway, Emergency Medicine, Shreveport, LA 71130 | 2020-03-31 |
| 1942837950 | Gabriel Sampognaro | Student in an Organized Health Care Education/Training Program | 1501 Kings Highway, Orthopaedic Surgery, Shreveport, LA 71130 | 2020-03-27 |
| 1679107049 | Negin Farsi | Student in an Organized Health Care Education/Training Program | 1501 Kings Highway, Pathology, Shreveport, LA 71130 | 2020-02-25 |
| 1962035600 | Somdipto Das | Student in an Organized Health Care Education/Training Program | 1501 Kings Highway, Oral Surgery, Shreveport, LA 71130 | 2020-02-21 |
| Find all providers in zip 71130 | ||||
| Taxonomy Code | 207R00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790315026 | Cody Tingle Md LLC | Internal Medicine | 535 Pierremont Rd, Shreveport, LA 71106-2207 | 2020-01-26 |
| 1538654306 | Masri Group LLC | Internal Medicine | 3801 Creswell Ave Unit 19, Shreveport, LA 71106-1257 | 2018-06-25 |
| 1982106456 | Hudson Amc LLC | Internal Medicine | 1800 Irving Place, Shreveport, LA 71101 | 2018-03-01 |
| 1760923064 | Martin Marak | Internal Medicine | 847 Prospect St, Shreveport, LA 71104-3025 | 2017-03-20 |
| 1265883482 | Vari LLC | Internal Medicine | 506 Rock Hollow Dr, Shreveport, LA 71115-2502 | 2016-06-29 |
| 1598140121 | Mihir V Patel Md LLC | Internal Medicine | 9930 Loveland Ct, Shreveport, LA 71106-7795 | 2015-07-24 |
| 1619357209 | Chad Michael Gibson | Internal Medicine | 8001 Youree Dr Ste 4007, Shreveport, LA 71115-2302 | 2015-06-09 |
| 1265829394 | Amanda Lynn Callegan-poche' | Internal Medicine | 1023 Provenance Pl Ste 130, Shreveport, LA 71106-7796 | 2015-04-15 |
| 1699017681 | Deanna Elise Mossallati | Internal Medicine | 8551 Greenwood Rd, Suite 410, Shreveport, LA 71103 | 2013-03-18 |
| 1477807980 | Ronald Baylis George | Internal Medicine | 1821 Willow Point Drive, Shreveport, LA 71119 | 2012-11-06 |
| Find all providers in SHREVEPORT | ||||
| City | SHREVEPORT |
| Zip Code | 71130 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.