| Doctor Name: | DR. MARK BURNETTE WALL |
| NPI Number: | 1053447268 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | M.D. |
| License Number: | 00025773 |
| Business Practice Address: | 150 Reynoir St Biloxi, MS - 395304130 |
| Business Phone Number: | 2284321571 |
| Business Fax Number: | |
| Mailing Address: | 202 Washington Ave, OCEAN SPRINGS |
| State: | MS |
| Postal Code: | 395644626 |
| Phone Number: | 2288750693 |
| Fax Number: | |
| NPI Enumeration Date: | 02/24/2007 |
| NPI Last Update Date: | 04/14/2016 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 2085R0202X |
| License Number: | 00025773 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | AL |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | Radiology |
| Taxonomy Specialization: | Diagnostic Radiology |
| Taxonomy Definition: | A radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease. |