Wakefield, Mark Richard

Wakefield, Mark Richard is an individual health care provider with primary practice located at One Hospital Drive , Columbia MO 65212-0001. He recently has only one registered license in Allopathic & Osteopathic Physicians / Urology, which is considered as his primary health care specialty. Wakefield, Mark Richard can be contacted via phone (573) 882-6500.

Contact Information

Primary practice address
One Hospital Drive Columbia MO 65212-0001
Phone: (573) 882-6500
Fax: (573) 884-7453
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Urology 208800000X 106072 Missouri

Profile Details

NPI number 1649226291
LBN Legal business name Wakefield, Mark Richard
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date May 25th, 2006
Last updated May 20th, 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1649226291 NPPES
Missouri MEDICAID 209289404
Missouri Other P00415790
Missouri Other P00147243

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