Dr. Mark Randal Comeaux
Periodontist
3839 West Congress Street Suite D
Lafayette
, Louisiana 70506-6021
Dr. Mark Randal Comeaux
Periodontist
3839 West Congress Street Suite D
Lafayette
, Louisiana 70506-6021
(337) 989-9030
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About
Features
Specialties
- Periodontist
Languages spoken
- English
Location
First Address
- Dr. Mark Randal Comeaux
- 3839 West Congress Street Suite D
- Lafayette, LA
- Zip : 70506-6021
- Fax : (337) 989-9030
- Phone : (337) 989-0267
Second Address
- Dr. Mark Randal Comeaux
- 3839 West Congress Street Suite D
- Lafayette, LA
- Zip : 70506-6021
- Fax : (337) 989-9030
- Phone : (337) 989-0267
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 1223P0300X | Periodontist | 3129 | LA |
National Provider Identifier
| NPI | 1083739486 |
|---|---|
| Provider Name | Dr. Mark Randal Comeaux |
| First Address | Lafayette, LA 70506-6021 |
| Second Address | Lafayette, LA 70506-6021 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 21/03/2007 |
| Last Update Date | 08/07/2007 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| U16975 | (02) | LA |
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.