Provider Demographics
NPI:1992707236
Name:GARCIA, FERNANDO (MD)
Entity type:Individual
Prefix:DR
First Name:FERNANDO
Middle Name:
Last Name:GARCIA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5541 HIGHWAY 1
Mailing Address - Street 2:
Mailing Address - City:MARKSVILLE
Mailing Address - State:LA
Mailing Address - Zip Code:71351-2650
Mailing Address - Country:US
Mailing Address - Phone:318-240-7240
Mailing Address - Fax:318-240-7180
Practice Address - Street 1:5541 HIGHWAY 1
Practice Address - Street 2:
Practice Address - City:MARKSVILLE
Practice Address - State:LA
Practice Address - Zip Code:71351-2650
Practice Address - Country:US
Practice Address - Phone:318-240-7240
Practice Address - Fax:318-240-7180
Is Sole Proprietor?:Yes
Enumeration Date:2005-06-01
Last Update Date:2012-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA05751R171W00000X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No171W00000XOther Service ProvidersContractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1319911Medicaid
LAB62836Medicare UPIN
LA1319911Medicaid
930080140Medicare PIN