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NPI Code Detail

MEDICARE: DR. MARK L BILLY DDS

MEDICARE: DR. MARK L BILLY DDS
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1204E00000XOral & Maxillofacial Surgery (D.M.D.)18346OH

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1538143508
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. MARK L BILLY DDS
Provider Business Mailing Address
First Line : 5437 MAHONING AVE
Second Line : SUITE 12
City : AUSTINTOWN
State : OH
Zip : 44515-2437
Country : US
Telephone Number : 330-792-2501
Fax Number : 330-792-9249
Provider Business Practice Location Address
First Line : 1001 COVINGTON ST
Second Line :
City : YOUNGSTOWN
State : OH
Zip : 44510-1617
Country : US
Telephone Number : 330-480-3195
Fax Number : 330-480-1366
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/02/2005
Last Update Date : 04/26/2022

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