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General NPI Number Information
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NPI Number | 1205917473
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Entity Type | Individual
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Provider Name | GREG B MARKESON OD
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Gender | Male
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Dates
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Enumeration Date | 10/17/2006
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Last Update Date | 09/23/2025
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Provider Practice Location Address
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Address Line | 1750 ROBERT ST S
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City | WEST ST PAUL
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State | MN
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Zip | 55118-3919
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Country | US
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Telephone | 651-306-0412
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Fax | 952-487-1447
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Provider Business Mailing Address
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Address Line | 1396 CHATTERTON RD
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City | EAGAN
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State | MN
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Zip | 55123-1480
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Country | US
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Telephone | 612-812-4691
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Fax |
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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 | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 2557
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License Number State | MN
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