Healthcare Provider Details

I. General information

NPI: 1861703860
Provider Name (Legal Business Name): MARK OERTEL MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/24/2010
Last Update Date: 05/12/2026
Certification Date: 05/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6265 ROCK CHALK DR STE 2700
LAWRENCE KS
66049-5232
US

IV. Provider business mailing address

325 MAINE ST
LAWRENCE KS
66044-1360
US

V. Phone/Fax

Practice location:
  • Phone: 785-505-5885
  • Fax: 785-505-5302
Mailing address:
  • Phone: 785-505-2988
  • Fax: 785-505-5228

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number9407504
License Number StateKS
# 2
Primary TaxonomyY
Taxonomy Code207RE0101X
TaxonomyEndocrinology, Diabetes & Metabolism Physician
License Number0436669
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: