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General NPI Number Information
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NPI Number | 1104848506
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Entity Type | Individual
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Provider Name | MARK E STURGILL D.O.
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Gender | Male
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Dates
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Enumeration Date | 07/24/2006
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Last Update Date | 09/16/2024
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Provider Practice Location Address
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Address Line | 215 W 17TH ST
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City | HOPKINSVILLE
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State | KY
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Zip | 42240-1911
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Country | US
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Telephone | 270-885-3414
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Fax | 270-885-7631
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Provider Business Mailing Address
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Address Line | PO BOX 595
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City | HOPKINSVILLE
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State | KY
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Zip | 42241-0595
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Country | US
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Telephone | 270-885-3414
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Fax | 270-885-7631
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | 02983
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License Number State | KY
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Taxonomy #2
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | DR.0053540
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License Number State | CO
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Taxonomy #3
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | 02002431A
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License Number State | IN
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