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NPI Code Detail

MEDICARE: MR. MARK D WEBSTER PA-C

MEDICARE: MR. MARK D WEBSTER PA-C
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
1363AM0700XMedical Physician Assistant1025OH

General Provider Information

NPI Number : 1952581944
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. MARK D WEBSTER PA-C
Provider Business Mailing Address
First Line : 2424 HILL AVE
Second Line :
City : MIDDLETOWN
State : OH
Zip : 45044-4732
Country : US
Telephone Number : 937-231-1250
Fax Number :
Provider Business Practice Location Address
First Line : 215 S ALLISON AVE
Second Line :
City : XENIA
State : OH
Zip : 45385-3694
Country : US
Telephone Number : 937-376-2571
Fax Number : 937-376-2930
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/07/2007
Last Update Date : 04/09/2013

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Directions to “ MR. MARK D WEBSTER PA-C” Practice Location

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