Irwin, Marc D

Irwin, Marc D is an individual health care provider with primary practice located at 911 23Rd St , Canyon TX 79015-4600. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Irwin, Marc D can be contacted via phone (806) 655-2104.

Contact Information

Primary practice address
911 23Rd St Canyon TX 79015-4600
Phone: (806) 655-2104
Fax: (806) 655-0522
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X K3255 Texas

Profile Details

NPI number 1972514974
LBN Legal business name Irwin, Marc D
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 11th, 2006
Last updated Dec 31st, 2015 - about 10 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 1972514974 NPPES
Texas Other 8A0911 BCBS
Texas MEDICAID 092485403 BCBS
Texas Other 115793100 BCBS
Texas MEDICAID 125233003 BCBS

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