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NPI Code Detail

MEDICARE: MARK FESEN MD

MEDICARE: MARK FESEN 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
1207RX0202XMedical Oncology Physician04-24425KS

General Provider Information

NPI Number : 1639149545
Entity Type Code : Individual
Provider Name (Legal Business Name) : MARK FESEN MD
Provider Business Mailing Address
First Line : PO BOX 256
Second Line :
City : SALINA
State : KS
Zip : 67402-0256
Country : US
Telephone Number : 785-823-0633
Fax Number : 785-823-0658
Provider Business Practice Location Address
First Line : 204 CLEVELAND ST
Second Line :
City : GREAT BEND
State : KS
Zip : 67530-3563
Country : US
Telephone Number : 620-792-5511
Fax Number : 620-792-5977
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/24/2006
Last Update Date : 10/10/2024

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