MEDICARE: MARK STARKEY

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	237700000X	Hearing Instrument Specialist	2007018578	MO

General Provider Information

NPI Number	:	1932500543
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARK STARKEY

Provider Business Mailing Address
First Line	:	1900 N PROVIDENCE RD
Second Line	:
City	:	COLUMBIA
State	:	MO
Zip	:	65202-3710
Country	:	US
Telephone Number	:	573-443-3401
Fax Number	:

Provider Business Practice Location Address
First Line	:	1900 N PROVIDENCE RD
Second Line	:
City	:	COLUMBIA
State	:	MO
Zip	:	65202-3710
Country	:	US
Telephone Number	:	573-443-3401
Fax Number	:

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

Provider Enumeration Date	:	09/15/2014
Last Update Date	:	09/15/2014

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Directions to “ MARK STARKEY ” Practice Location

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