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General NPI Number Information
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NPI Number | 1588769301
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Entity Type | Organization
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Legal Business Name | MARK S CHOWN MDPA
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Dates
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Enumeration Date | 09/14/2006
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Last Update Date | 09/11/2025
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Provider Practice Location Address
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Address Line | 1611 C 12TH AVE RD
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City | NAMPA
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State | ID
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Zip | 83686-6182
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Country | US
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Telephone | 208-466-3322
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Fax | 208-465-0392
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Provider Business Mailing Address
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Address Line | 1611 C 12TH AVE RD
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City | NAMPA
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State | ID
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Zip | 83686-6182
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Country | US
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Telephone | 208-466-3322
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Fax | 208-465-0392
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Authorized Official
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Title or Position | CORP PRESIDENT
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Name | DR. MARK S CHOWN
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Credential | MD
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Telephone | 208-466-3322
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | M4350
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License Number State | ID
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Taxonomy #2
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Taxonomy Code | 2086S0129X
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Taxonomy Name | Vascular Surgery Physician
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License Number | M4350
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License Number State | ID
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