Thibert, Mark
Thibert, Mark is an individual health care provider with primary practice located at 375 Nw Beaver St Ste 101 , Prineville OR 97754-1802. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Family Medicine, Allopathic & Osteopathic Physicians / Internal Medicine. Allopathic & Osteopathic Physicians / Internal Medicine is his primary health care specialty. Thibert, Mark can be contacted via phone (541) 383-3005.Contact Information
Primary practice address
375 Nw Beaver St Ste 101
Prineville OR 97754-1802
Phone: (541) 383-3005
Fax: (541) 383-1883
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | MD169232 | Oregon |
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | 5190415-1205 | Utah |
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | MD00048052 | Washington |
| Allopathic & Osteopathic Physicians / Internal Medicine | 207R00000X | MD169232 | Oregon |
Profile Details
| NPI number | 1225104235 |
|---|---|
| LBN Legal business name | Thibert, Mark |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Nov 28th, 2006 |
| Last updated | Oct 9th, 2024 - about 2 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 | 1225104235 | NPPES |
| Oregon | MEDICAID | 500678702 |
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