Mouty, Mark Patrick

Mouty, Mark Patrick is an individual health care provider with primary practice located at 751 Old Richardson Hwy Ste # 200, Fairbanks AK 99701-7813. He recently has 3 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, Physician Assistants & Advanced Practice Nursing Providers / Medical, Physician Assistants & Advanced Practice Nursing Providers / Surgical. Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant is his primary health care specialty. Mouty, Mark Patrick can be contacted via phone (907) 451-6561.

Contact Information

Primary practice address
751 Old Richardson Hwy Ste # 200 Fairbanks AK 99701-7813
Phone: (907) 451-6561
Fax: (907) 451-4847
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X 696 Alaska
Physician Assistants & Advanced Practice Nursing Providers / Medical 363AM0700X 696 Alaska
Physician Assistants & Advanced Practice Nursing Providers / Surgical 363AS0400X 696 Alaska

Profile Details

NPI number 1538191861
LBN Legal business name Mouty, Mark Patrick
Credentials Physician's Assistant Certified (PA-C)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 7th, 2006
Last updated Jul 9th, 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1538191861 NPPES
Alaska Other 696 STATE MEDICAL LICENSE

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