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NPI Code Detail

MEDICARE: DR. MARK HOUSLEY MD

MEDICARE: DR. MARK HOUSLEY MD
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
1207Q00000XFamily Medicine Physician5358316-105UT

General Provider Information

NPI Number : 1457358335
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. MARK HOUSLEY MD
Provider Business Mailing Address
First Line : 2240 ADAMS AVE
Second Line :
City : OGDEN
State : UT
Zip : 84401-1511
Country : US
Telephone Number : 801-393-5355
Fax Number : 801-394-4609
Provider Business Practice Location Address
First Line : 2240 ADAMS AVE
Second Line :
City : OGDEN
State : UT
Zip : 84401-1511
Country : US
Telephone Number : 801-393-5355
Fax Number : 801-394-4609
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/07/2005
Last Update Date : 10/27/2011

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Directions to “ DR. MARK HOUSLEY MD” Practice Location

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