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NPI Code Detail

MEDICARE: RUFUS J. MARK

MEDICARE: RUFUS J. MARK
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
12085R0001XRadiation Oncology Physician46094AZ

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
3920006823OTHERTXRAILROAD MEDICARE
4P00607340OTHERNMRAILROAD MEDICARE

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1992786628
Entity Type Code : Individual
Provider Name (Legal Business Name) : RUFUS J. MARK
Provider Business Mailing Address
First Line : PO BOX 24120
Second Line :
City : KNOXVILLE
State : TN
Zip : 37933-2120
Country : US
Telephone Number : 865-803-4321
Fax Number : 580-250-5183
Provider Business Practice Location Address
First Line : 421 SOUTH MAIN STREET
Second Line :
City : CROSSVILLE
State : TN
Zip : 38555-5048
Country : US
Telephone Number : 931-456-8390
Fax Number : 931-456-8389
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/09/2005
Last Update Date : 07/11/2024

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