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General NPI Number Information
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NPI Number | 1962538918
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Entity Type | Organization
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Legal Business Name | MARK ORGEL, MD, PLLC
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Dates
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Enumeration Date | 02/26/2007
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Last Update Date | 12/15/2008
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Provider Practice Location Address
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Address Line | 532 NORTH BARDSTOWN ROAD
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City | MT WASHINGTON
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State | KY
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Zip | 40047
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Country | US
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Telephone | 502-538-4800
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Fax | 502-538-3040
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Provider Business Mailing Address
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Address Line | PO BOX 67
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City | MT WASHINGTON
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State | KY
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Zip | 40047-0067
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Country | US
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Telephone | 502-538-4800
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Fax | 502-538-3040
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Authorized Official
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Title or Position | OWNER
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Name | MARK HENRY ORGEL
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Credential | M.D.
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Telephone | 502-538-4800
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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 | 24091
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License Number State | KY
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