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General NPI Number Information
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NPI Number | 1598711673
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Entity Type | Individual
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Provider Name | ROBERT D MARKS MD
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Gender | Male
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Dates
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Enumeration Date | 05/26/2006
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Last Update Date | 05/29/2013
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Provider Practice Location Address
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Address Line | 305 E MAIN ST
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City | ENNIS
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State | MT
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Zip | 59729-9043
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Country | US
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Telephone | 406-682-4223
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Fax | 406-682-3874
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Provider Business Mailing Address
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Address Line | 305 N. MAIN
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City | ENNIS
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State | MT
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Zip | 59729
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Country | US
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Telephone | 406-682-4223
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Fax | 406-682-3874
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 5291
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License Number State | MT
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