Provider Demographics
NPI:1831273853
Name:MARX, DONALD E (DC)
Entity type:Individual
Prefix:DR
First Name:DONALD
Middle Name:E
Last Name:MARX
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:825 N EASTERN AVE
Mailing Address - Street 2:
Mailing Address - City:CROWLEY
Mailing Address - State:LA
Mailing Address - Zip Code:70526-3858
Mailing Address - Country:US
Mailing Address - Phone:337-783-1007
Mailing Address - Fax:337-783-5458
Practice Address - Street 1:825 N EASTERN AVE
Practice Address - Street 2:
Practice Address - City:CROWLEY
Practice Address - State:LA
Practice Address - Zip Code:70526-3858
Practice Address - Country:US
Practice Address - Phone:337-783-1007
Practice Address - Fax:337-783-5458
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-25
Last Update Date:2008-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA291111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA20128OtherBLUE CROSS/BLUE SHIELD
LA1952397Medicaid
LA20128OtherBLUE CROSS/BLUE SHIELD
LAT19913Medicare UPIN