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General NPI Number Information
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NPI Number | 1871838268
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Entity Type | Organization
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Legal Business Name | MARK S. NAISBITT, MD, PC
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Dates
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Enumeration Date | 12/11/2012
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Last Update Date | 12/11/2012
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Provider Practice Location Address
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Address Line | 4401 HARRISON BLVD MCKAY DEE HOSPITAL
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City | OGDEN
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State | UT
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Zip | 84403-3195
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Country | US
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Telephone | 801-589-2006
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Fax |
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Provider Business Mailing Address
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Address Line | 3460 BAKER DR
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City | OGDEN
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State | UT
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Zip | 84403-1310
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Country | US
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Telephone | 801-392-1401
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. MARK S. NAISBITT
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Credential | M.D.
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Telephone | 801-392-1401
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207LP2900X
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Taxonomy Name | Pain Medicine (Anesthesiology) Physician
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License Number | 184191-1205
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License Number State | UT
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