Double, Mark
Double, Mark is an individual health care provider with primary practice located at 205 N East Ave , Jackson MI 49201-1753. He recently has only one registered license in Allopathic & Osteopathic Physicians / Anesthesiology, which is considered as his primary health care specialty. Double, Mark can be contacted via phone (517) 788-4963.Contact Information
Primary practice address
205 N East Ave
Jackson MI 49201-1753
Phone: (517) 788-4963
Fax: (517) 789-5903
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Anesthesiology | 207L00000X | 51-01-011675 | Michigan |
Profile Details
| NPI number | 1669403903 |
|---|---|
| LBN Legal business name | Double, Mark |
| Credentials | Doctor of Osteopathy (DO) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jul 5th, 2006 |
| Last updated | Jul 8th, 2007 - about 18 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1669403903 | NPPES |
| Michigan | MEDICAID | 4586940 |
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