Dr. Mack Jay Groves IV
Podiatrist Foot Surgery Primary Podiatric Medicine
323 S Tyler St
Covington
, Louisiana 70433-3037
Dr. Mack Jay Groves IV
Podiatrist Foot Surgery Primary Podiatric Medicine
323 S Tyler St
Covington
, Louisiana 70433-3037
(985) 867-9001
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About
Features
Specialties
- Podiatrist
- Primary Podiatric Medicine
- Foot Surgery
Languages spoken
- English
Location
First Address
- Dr. Mack Jay Groves IV
- 802 W 10th Ave Suite 2
- Covington, LA
- Zip : 70433-2352
- Fax : (985) 867-9001
- Phone : (985) 867-9605
Second Address
- Dr. Mack Jay Groves IV
- 323 S Tyler St
- Covington, LA
- Zip : 70433-3037
- Fax : (985) 867-9001
- Phone : (985) 867-9605
Reviews
FAQs
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Is Dr. Mack Jay Groves IV a sole practitioner?
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| N | 213E00000X | Podiatrist | PD190R | LA |
| N | 222Z00000X | Podiatrist | PD190R | LA |
| Y | 213EP1101X | Primary Podiatric Medicine | DPM.190R | LA |
| N | 213ES0131X | Foot Surgery | PD190R | LA |
National Provider Identifier
| NPI | 1265460877 |
|---|---|
| Provider Name | Dr. Mack Jay Groves IV |
| First Address | Covington, LA 70433-2352 |
| Second Address | Covington, LA 70433-3037 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | Yes |
| Is Organization Subpart | N/A |
| Enumeration Date | 30/06/2006 |
| Last Update Date | 06/09/2019 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| 1265460877 | BLUECROSS (01) |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.