MEDICARE: DR. WILLIAM PARKER MARKS JR. M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207W00000X	Ophthalmology Physician	030829	GA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1356337448
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. WILLIAM PARKER MARKS JR. M.D.

Provider Business Mailing Address
First Line	:	125 OAKSIDE CT
Second Line	:	SUITE 102
City	:	CANTON
State	:	GA
Zip	:	30114-2498
Country	:	US
Telephone Number	:	678-880-0662
Fax Number	:	678-880-0675

Provider Business Practice Location Address
First Line	:	125 OAKSIDE CT
Second Line	:	SUITE 102
City	:	CANTON
State	:	GA
Zip	:	30114-2498
Country	:	US
Telephone Number	:	678-880-0662
Fax Number	:	678-880-0675

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/23/2005
Last Update Date	:	07/14/2010

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