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General NPI Number Information
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NPI Number | 1659317881
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Entity Type | Individual
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Provider Name | KATHY ANN MARKS M.D.
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Gender | Female
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Dates
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Enumeration Date | 06/22/2006
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Last Update Date | 05/16/2014
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Provider Practice Location Address
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Address Line | 137 MEDICAL LN
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City | POLLOCKSVILLE
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State | NC
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Zip | 28573-8200
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Country | US
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Telephone | 252-633-1010
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Fax | 252-224-3071
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Provider Business Mailing Address
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Address Line | PO BOX 602522
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City | CHARLOTTE
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State | NC
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Zip | 28260-2522
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Country | US
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Telephone | 252-633-1010
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Fax | 252-224-3071
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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 | 207RP1001X
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Taxonomy Name | Pulmonary Disease Physician
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License Number | 2009-00307
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License Number State | NC
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