Wallingford, Mark Allen
Wallingford, Mark Allen is an individual health care provider with primary practice located at 2009 Old Main Street , Maysville KY 41056. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Internal Medicine, Allopathic & Osteopathic Physicians / Pediatrics. Allopathic & Osteopathic Physicians / Internal Medicine is his primary health care specialty. Wallingford, Mark Allen can be contacted via phone (606) 759-7615.Contact Information
Primary practice address
2009 Old Main Street
Maysville KY 41056
Phone: (606) 759-7615
Fax: (606) 759-7821
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Internal Medicine | 207R00000X | 24430 | Kentucky |
| Allopathic & Osteopathic Physicians / Pediatrics | 208000000X | 24430 | Kentucky |
Profile Details
| NPI number | 1205919875 |
|---|---|
| LBN Legal business name | Wallingford, Mark Allen |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Oct 24th, 2006 |
| Last updated | Jan 30th, 2017 - about 8 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 | 1205919875 | NPPES |
| Kentucky | MEDICAID | 64244304 |
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