Active NPI 1245200880 Individual Practitioner Male Practitioner

Dr. Mark Blackwelder , MD

Internal Medicine • Ruston, LA

✓ Accepts Medicare Assignment

Professional Overview & Biography Verified Profile Summary

Dr. Mark Blackwelder, MD is a certified Internal Medicine practicing in Ruston, LA. With approximately 41 years of clinical experience since graduating from Louisiana State University School Of Medicine In Shreveport in 1985, Dr. Blackwelder delivers high-quality medical care to the local community at 1200 S FARMERVILLE ST.

Dr. Blackwelder is affiliated with Green Clinic Llc and accepts Medicare assignment.

Frequently performed procedures and clinical services include injection, denosumab, 1 mg, injection, methylprednisolone acetate, 1 mg, subsequent hospital care with moderate levelof medical decision making, if using time, at least. Full Medicare procedure pricing transparency rates and service volume details are listed on this profile.

Practice Location & Contact Primary Location

Practice Address

1200 S Farmerville St

Ruston, LA 712705941

Telephone 3182553690

Associated Practice Facility / Clinic

🏢 Green Clinic Llc Facility NPI 1831178755

Medicare Profile & Education

Medical School

Louisiana State University School Of Medicine In Shreveport

Graduation Year

1985

Medicare Assignment

✓ Accepts Assignment

Telehealth Flag

In-Person Only

Specialty Benchmarks & Practice Insights

Comparative analytics for Internal Medicine in Ruston, LA

Senior Veteran Specialist (>20 Yrs)

Practitioner Clinical Experience

41 Yrs +5.5 yrs vs City Avg

City Avg: 35.5 Yrs

State Avg: 27.4 Yrs

Regional Practice Density

9 Specialists

Practicing in Ruston, LA (1847 Statewide)

Telehealth Adoption Rate

0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount

42.7% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Clinical Seniority & Experience Comparison

Dr. Blackwelder (41 Years) 41 Yrs

Ruston Specialty Average (35.5 Years) 35.5 Yrs

Performed Procedures & Service Volume

Top Medicare Part B procedures performed by this practitioner

CMS Official Data (2024)

Reporting Year:

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
J0897 Injection, denosumab, 1 mg	1,560	22	$50.00	$25.09
J1010 Injection, methylprednisolone acetate, 1 mg	1,000	12	$0.30	$0.13
99232 Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes	870	148	$115.00	$73.32
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	576	217	$206.00	$118.14
99233 Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes	269	105	$164.00	$111.08
99213 Established patient office or other outpatient visit, typically 15 minutes	156	100	$145.75	$83.47
J0702 Injection, betamethasone acetate 3 mg and betamethasone sodium phosphate 3 mg	134	27	$11.00	$6.94
96372 Injection beneath the skin or into muscle for therapy, diagnosis, or prevention	98	62	$41.00	$13.09
99238 Hospital discharge day management, 30 minutes or less	92	82	$135.00	$75.52
99223 Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes	76	64	$315.00	$160.60
G0179 Physician re-certification for medicare-covered home health services under a home health plan of care (patient not present), including contacts with home health agency and review of reports of patient status required by physicians to affirm the initial imp	38	17	$70.00	$38.18
99496 Transitional care management services for problem of high complexity	25	20	$445.00	$256.96
99215 Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more	16	14	$218.00	$167.82
93000 Routine ekg using at least 12 leads including interpretation and report	15	13	$65.00	$13.05
G0439 Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit	13	13	$225.00	$120.26

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
J0897 Injection, denosumab, 1 mg	2,580	24	$50.00	$23.24
99232 Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes	1,467	219	$115.00	$75.63
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	599	238	$195.93	$119.26
99233 Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes	322	132	$164.00	$114.00
99223 Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes	143	111	$315.00	$165.50
96372 Injection beneath the skin or into muscle for therapy, diagnosis, or prevention	130	69	$41.00	$12.92
99238 Hospital discharge day management, 30 minutes or less	123	93	$135.00	$77.00
99213 Established patient office or other outpatient visit, typically 15 minutes	113	82	$141.99	$83.31
J0702 Injection, betamethasone acetate 3 mg and betamethasone sodium phosphate 3 mg	107	24	$11.00	$6.61
G0008 Administration of influenza virus vaccine	50	50	$35.00	$28.41
J1030 Injection, methylprednisolone acetate, 40 mg	39	17	$13.00	$6.89
93000 Routine ekg using at least 12 leads including interpretation and report	39	34	$65.00	$13.42
90674 Influenza vaccine, quadrivalent derived from cell cultures, preservative and antibiotic free	37	37	$65.00	$32.48
99496 Transitional care management services for problem of high complexity	33	25	$430.00	$257.72
J3420 Injection, vitamin b-12 cyanocobalamin, up to 1000 mcg	30	11	$13.00	$1.54
G0179 Physician re-certification for medicare-covered home health services under a home health plan of care (patient not present), including contacts with home health agency and review of reports of patient status required by physicians to affirm the initial imp	26	14	$70.00	$38.27
90662 Influenza vaccine split virus, preservative free	13	13	$135.00	$71.93
99215 Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more	12	11	$218.00	$168.70

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
J0897 Injection, denosumab, 1 mg	2,880	27	$50.00	$21.63
99232 Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes	2,208	298	$115.00	$69.68
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	553	231	$161.00	$122.72
99223 Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes	164	129	$315.00	$194.17
99238 Hospital discharge day management, 30 minutes or less	151	118	$135.00	$69.59
J0702 Injection, betamethasone acetate 3 mg and betamethasone sodium phosphate 3 mg	132	30	$11.00	$6.61
99213 Established patient office or other outpatient visit, typically 15 minutes	127	91	$130.81	$86.02
96372 Injection beneath the skin or into muscle for therapy, diagnosis, or prevention	113	69	$41.00	$13.46
99233 Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes	101	63	$164.00	$96.15
G0008 Administration of influenza virus vaccine	56	52	$33.82	$26.46
93000 Routine ekg using at least 12 leads including interpretation and report	43	38	$65.00	$13.80
90662 Influenza vaccine split virus, preservative free	33	32	$134.09	$68.24
G0179 Physician re-certification for medicare-covered home health services under a home health plan of care (patient not present), including contacts with home health agency and review of reports of patient status required by physicians to affirm the initial imp	31	11	$70.00	$38.89
99496 Transitional care management services for problem of high complexity	28	25	$336.33	$256.74
J1030 Injection, methylprednisolone acetate, 40 mg	25	13	$13.00	$5.84
99231 Follow-up hospital inpatient care per day, typically 15 minutes	25	16	$75.00	$38.26
99215 Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more	21	19	$218.00	$176.08
90674 Influenza vaccine, quadrivalent derived from cell cultures, preservative and antibiotic free	20	20	$65.00	$31.63
G0180 Physician or allowed practitioner certification for medicare-covered home health services under a home health plan of care (patient not present), including contacts with home health agency and review of reports of patient status required by physicians and	14	14	$93.00	$50.93

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
J0897 Injection, denosumab, 1 mg	2,580	25	$50.00	$20.63
99232 Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes	2,080	283	$115.00	$69.15
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	503	242	$161.00	$122.93
99233 Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes	234	116	$164.00	$95.44
J0702 Injection, betamethasone acetate 3 mg and betamethasone sodium phosphate 3 mg	157	30	$11.00	$6.91
99223 Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes	141	121	$315.00	$182.83
99238 Hospital discharge day management, 30 minutes or less	134	114	$135.00	$66.00
96372 Injection beneath the skin or into muscle for therapy, diagnosis, or prevention	119	78	$41.00	$13.28
99213 Established patient office or other outpatient visit, typically 15 minutes	102	75	$109.47	$87.20
J1030 Injection, methylprednisolone acetate, 40 mg	48	24	$13.00	$5.67
99215 Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more	46	36	$217.96	$165.08
93000 Routine ekg using at least 12 leads including interpretation and report	35	31	$65.00	$13.75
G0008 Administration of influenza virus vaccine	33	33	$22.00	$15.34
99496 Transitional care management services for problem of high complexity	30	24	$262.80	$231.43
90662 Influenza vaccine split virus, preservative free	24	24	$125.00	$62.54
0012A Adm sarscov2 100mcg/0.5ml2nd	11	11	$57.00	$36.09

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
J0897 Injection, denosumab, 1 mg	2,400	22	$50.00	$19.62
99232 Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes	2,162	285	$115.00	$71.59
99213 Established patient office or other outpatient visit, typically 15 minutes	382	181	$107.00	$71.32
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	308	196	$161.00	$103.66
99233 Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes	203	123	$164.00	$101.24
J0702 Injection, betamethasone acetate 3 mg and betamethasone sodium phosphate 3 mg	138	25	$11.00	$6.93
99238 Hospital discharge day management, 30 minutes or less	131	113	$135.00	$70.24
96372 Injection beneath the skin or into muscle for therapy, diagnosis, or prevention	128	74	$41.00	$13.36
99223 Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes	115	105	$315.00	$199.07
G0008 Administration of influenza virus vaccine	80	77	$22.00	$15.61
90662 Influenza vaccine split virus, preservative free	67	64	$59.84	$58.65
J1030 Injection, methylprednisolone acetate, 40 mg	54	23	$13.00	$5.86
G0179 Physician re-certification for medicare-covered home health services under a home health plan of care (patient not present), including contacts with home health agency and review of reports of patient status required by physicians to affirm the initial imp	41	16	$70.00	$38.84
93000 Routine ekg using at least 12 leads including interpretation and report	27	26	$65.00	$15.99
99496 Transitional care management services for problem of high complexity	20	19	$250.00	$222.55
99215 Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more	19	16	$217.00	$135.50
90686 Vaccine for influenza for administration into muscle, 0.5 ml dosage	12	12	$25.00	$19.58
G0009 Administration of pneumococcal vaccine	12	12	$30.00	$15.78
36415 Insertion of needle into vein for collection of blood sample	12	11	$14.00	$2.74
99222 Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes	12	12	$214.00	$131.85
G0180 Physician or allowed practitioner certification for medicare-covered home health services under a home health plan of care (patient not present), including contacts with home health agency and review of reports of patient status required by physicians and	11	11	$93.00	$51.03

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99232 Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes	2,073	313	$115.00	$70.79
J0897 Injection, denosumab, 1 mg	1,860	21	$50.00	$18.67
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	454	250	$161.00	$102.91
99213 Established patient office or other outpatient visit, typically 15 minutes	379	186	$107.00	$70.54
99233 Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes	259	172	$164.00	$100.83
J0702 Injection, betamethasone acetate 3 mg and betamethasone sodium phosphate 3 mg	230	41	$11.00	$6.52
99223 Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes	137	127	$315.00	$194.47
99238 Hospital discharge day management, 30 minutes or less	133	117	$135.00	$71.17
96372 Injection beneath the skin or into muscle for therapy, diagnosis, or prevention	130	89	$41.00	$15.42
G0008 Administration of influenza virus vaccine	115	113	$22.00	$15.24
90686 Vaccine for influenza for administration into muscle, 0.5 ml dosage	68	68	$25.00	$18.65
99308 Subsequent nursing facility care with straightforward level of medical decision making, per day, if using time, at least 15 minutes	45	13	$104.00	$66.88
90662 Influenza vaccine split virus, preservative free	45	45	$54.62	$50.94
99309 Subsequent nursing facility care with moderate level of medical decision making, per day, if using time, at least 30 minutes	44	13	$137.00	$89.07
J1030 Injection, methylprednisolone acetate, 40 mg	44	21	$13.00	$6.34
G0179 Physician re-certification for medicare-covered home health services under a home health plan of care (patient not present), including contacts with home health agency and review of reports of patient status required by physicians to affirm the initial imp	37	12	$70.00	$38.82
93000 Routine ekg using at least 12 leads including interpretation and report	33	33	$65.00	$16.08
99496 Transitional care management services for problem of high complexity	31	29	$250.00	$220.29
J1885 Injection, ketorolac tromethamine, per 15 mg	30	11	$17.00	$0.53
99215 Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more	21	19	$217.00	$139.65
G0009 Administration of pneumococcal vaccine	16	16	$30.00	$15.51
99220 Hospital observation care, typically 70 minutes	14	13	$250.00	$182.18
99305 Initial nursing facility care with moderate level of medical decision making, per day, if using time, at least 35 minutes	14	13	$198.00	$127.07
90732 Vaccine for pneumococcal polysaccharide for injection beneath the skin or into muscle, patient 2 years or older	12	12	$110.27	$107.81

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99232 Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes	2,444	327	$115.00	$70.95
J0897 Injection, denosumab, 1 mg	2,042	20	$50.00	$17.90
99213 Established patient office or other outpatient visit, typically 15 minutes	476	236	$107.00	$69.47
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	459	267	$161.00	$101.85
J0702 Injection, betamethasone acetate 3 mg and betamethasone sodium phosphate 3 mg	318	56	$10.93	$7.09
99233 Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes	196	116	$164.00	$102.27
99238 Hospital discharge day management, 30 minutes or less	163	124	$135.00	$71.16
99223 Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes	157	134	$315.00	$198.57
96372 Injection beneath the skin or into muscle for therapy, diagnosis, or prevention	125	100	$41.00	$19.06
G0008 Administration of influenza virus vaccine	120	118	$22.05	$18.61
85610 Blood test, clotting time	85	11	$22.00	$4.75
90662 Influenza vaccine split virus, preservative free	81	81	$53.00	$51.30
99308 Subsequent nursing facility care with straightforward level of medical decision making, per day, if using time, at least 15 minutes	63	12	$104.00	$67.17
99309 Subsequent nursing facility care with moderate level of medical decision making, per day, if using time, at least 30 minutes	47	17	$137.00	$88.83
99496 Transitional care management services for problem of high complexity	45	36	$250.00	$220.85
J1030 Injection, methylprednisolone acetate, 40 mg	39	18	$13.00	$6.67
99215 Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more	38	36	$217.00	$139.11
G0179 Physician re-certification for medicare-covered home health services under a home health plan of care (patient not present), including contacts with home health agency and review of reports of patient status required by physicians to affirm the initial imp	37	12	$70.00	$39.24
93000 Routine ekg using at least 12 leads including interpretation and report	32	28	$65.00	$15.94
90674 Influenza vaccine, quadrivalent derived from cell cultures, preservative and antibiotic free	31	30	$25.06	$22.81
99305 Initial nursing facility care with moderate level of medical decision making, per day, if using time, at least 35 minutes	29	17	$198.00	$127.02
96401 Administration of non-hormonal anti-neoplastic chemotherapy under skin or into muscle	19	17	$150.00	$73.02
G0009 Administration of pneumococcal vaccine	17	17	$30.00	$18.93
G0180 Physician or allowed practitioner certification for medicare-covered home health services under a home health plan of care (patient not present), including contacts with home health agency and review of reports of patient status required by physicians and	16	14	$93.00	$50.99
90670 Pneumococcal vaccine for injection into muscle	13	13	$248.00	$198.19

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99232 Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes	2,116	249	$115.00	$70.33
J0897 Injection, denosumab, 1 mg	1,320	15	$50.00	$16.67
99213 Established patient office or other outpatient visit, typically 15 minutes	656	259	$107.00	$68.94
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	384	249	$161.00	$101.60
J0702 Injection, betamethasone acetate 3 mg and betamethasone sodium phosphate 3 mg	350	55	$10.94	$6.39
96372 Injection beneath the skin or into muscle for therapy, diagnosis, or prevention	161	89	$41.00	$22.96
99223 Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes	153	132	$315.00	$197.67
G0008 Administration of influenza virus vaccine	137	135	$23.04	$22.24
99238 Hospital discharge day management, 30 minutes or less	123	99	$135.00	$70.21
99233 Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes	119	72	$164.00	$101.95
Q2039 Influenza virus vaccine, not otherwise specified	112	112	$27.00	$22.33
85610 Blood test, clotting time	106	14	$22.00	$5.26
G0179 Physician re-certification for medicare-covered home health services under a home health plan of care (patient not present), including contacts with home health agency and review of reports of patient status required by physicians to affirm the initial imp	56	20	$70.00	$38.85
93000 Routine ekg using at least 12 leads including interpretation and report	55	52	$65.00	$15.79
99211 Office or other outpatient visit for the evaluation and management of established patient that may not require presence of healthcare professional	53	13	$40.00	$18.74
J1030 Injection, methylprednisolone acetate, 40 mg	52	23	$13.00	$5.85
99308 Subsequent nursing facility care with straightforward level of medical decision making, per day, if using time, at least 15 minutes	50	12	$104.00	$66.75
99309 Subsequent nursing facility care with moderate level of medical decision making, per day, if using time, at least 30 minutes	48	15	$137.00	$88.14
99496 Transitional care management services for problem of high complexity	40	34	$250.00	$218.52
J1885 Injection, ketorolac tromethamine, per 15 mg	32	12	$17.00	$0.63
96401 Administration of non-hormonal anti-neoplastic chemotherapy under skin or into muscle	25	17	$150.00	$67.24
G0009 Administration of pneumococcal vaccine	24	24	$30.00	$23.25
99305 Initial nursing facility care with moderate level of medical decision making, per day, if using time, at least 35 minutes	21	16	$198.00	$122.97
99222 Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes	18	15	$230.83	$130.28
90670 Pneumococcal vaccine for injection into muscle	18	18	$248.00	$184.38
G0180 Physician or allowed practitioner certification for medicare-covered home health services under a home health plan of care (patient not present), including contacts with home health agency and review of reports of patient status required by physicians and	16	15	$93.00	$50.84
90662 Influenza vaccine split virus, preservative free	15	15	$47.00	$46.06
99220 Hospital observation care, typically 70 minutes	14	14	$250.00	$181.73
J7620 Albuterol, up to 2.5 mg and ipratropium bromide, up to 0.5 mg, fda-approved final product, non-compounded, administered through dme	14	12	$10.00	$0.16
94640 Inhalation treatment for airway obstruction or sputum production	11	11	$40.00	$16.45
90732 Vaccine for pneumococcal polysaccharide for injection beneath the skin or into muscle, patient 2 years or older	11	11	$98.55	$95.06

Medical Specialties & State Licenses

Internal Medicine Primary Specialty

NUCC Taxonomy Code: 207R00000X

State License LA 18456

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.

Hospital & Practice Group Affiliations

Green Clinic Llc

1200 S Farmerville St, Ruston, LA 712705941

Phone: 3182553690

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

40 Associated Practitioners

Dr. Paul Novakovich , MD

Orthopaedic Surgery

NPI 1023227683

Doctor of Medicine (M.D.)

Mary Cantrell , NP

Nurse Practitioner - Family

NPI 1063908135

Nurse Practitioner

Dr. Richard Ballard , MD

Orthopaedic Surgery

NPI 1073583613

Doctor of Medicine (M.D.)

Erin Lancaster , FNP-C

Nurse Practitioner - Family

NPI 1104399393

Family Nurse Practitioner (Certified)

Dr. Robert Harper , MD

Obstetrics & Gynecology

NPI 1154391605

Doctor of Medicine (M.D.)

Dr. George Smith , MD

Internal Medicine - Cardiovascular Disease

NPI 1164492484

Doctor of Medicine (M.D.)

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

6 Historical Events

✅

NPI Profile Active October 15, 2009

NPI status registered as active in NPPES database

📍

Updated Practice Location October 15, 2009

Registered at 1200 S FARMERVILLE ST, RUSTON, LA 712705941 (Tel: 3182553690)

📍

Updated Business Mailing Address October 15, 2009

Registered at 1200 S FARMERVILLE ST, RUSTON, LA 712705941 (Tel: 3182553690)

👤

Provider Name / Credentials Updated October 15, 2009

Recorded as MARK BLACKWELDER, M.D.

🎓

Medical Taxonomy / Specialty Registered (Primary Specialty) October 15, 2009

Internal Medicine (License #18456 in LA)

🟢

Initial NPI Registration & Enumeration January 25, 2006

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1245200880

Entity Type:

Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)

Enumeration Date: January 25, 2006

Last Update: October 15, 2009

Sole Proprietor: No

Update or Correct Profile

Mailing Address

1200 S Farmerville St

Ruston, LA 712705941

Phone: 3182553690

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).

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This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.