Dobbertien, Mark Alan

Dobbertien, Mark Alan is an individual health care provider with primary practice located at 655 W 8Th St Ufjp Surgery Department, Jacksonville FL 32209-6511. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Emergency Medicine, Allopathic & Osteopathic Physicians / Surgery. Allopathic & Osteopathic Physicians / Surgery is his primary health care specialty. Dobbertien, Mark Alan can be contacted via phone (904) 383-1015.

Contact Information

Primary practice address
655 W 8Th St Ufjp Surgery Department Jacksonville FL 32209-6511
Phone: (904) 383-1015
Fax: (904) 244-6252
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Emergency Medicine 207P00000X OS 6627 Florida
Allopathic & Osteopathic Physicians / Surgery 208600000X OS 6627 Florida

Profile Details

NPI number 1265407043
LBN Legal business name Dobbertien, Mark Alan
Credentials Doctor of Osteopathy (DO)
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 23rd, 2006
Last updated Jan 11th, 2011 - about 15 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1265407043 NPPES
Florida Other 930071111 RR MEDICARE
Florida MEDICAID 3738060-00 RR MEDICARE
Florida MEDICAID 00744004A RR MEDICARE
Florida MEDICAID 2748282-00 RR MEDICARE

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