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General NPI Number Information
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NPI Number | 1578248233
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Entity Type | Individual
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Provider Name | ROBERT HENRY MARKS AGCNP
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Gender | Male
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Dates
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Enumeration Date | 06/20/2023
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Last Update Date | 06/20/2023
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Provider Practice Location Address
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Address Line | 1200 MEMORIAL DR
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City | DALTON
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State | GA
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Zip | 30720-2529
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Country | US
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Telephone | 706-272-6000
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Fax |
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Provider Business Mailing Address
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Address Line | 8538 E SELLS DR
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City | SCOTTSDALE
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State | AZ
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Zip | 85251-2848
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Country | US
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Telephone | 602-989-3902
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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 | 363LA2100X
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Taxonomy Name | Acute Care Nurse Practitioner
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License Number | 289189
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License Number State | AZ
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Taxonomy #2
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Taxonomy Code | 363LA2100X
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Taxonomy Name | Acute Care Nurse Practitioner
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License Number | GAA-NP001479
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License Number State | GA
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