Doctor Name: | DR. MARK T MESSENGER |
NPI Number: | 1164414769 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | D.P.M. |
License Number: | POD000713 |
Business Practice Address: | 1043 Washington Rd Thomson, GA - 308247318 |
Business Phone Number: | 7065970101 |
Business Fax Number: | 7065971998 |
Mailing Address: | 1043 Washington Rd, THOMSON |
State: | GA |
Postal Code: | 308247318 |
Phone Number: | 7065970101 |
Fax Number: | 7065971998 |
NPI Enumeration Date: | 08/19/2005 |
NPI Last Update Date: | 09/25/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 213ES0103X |
License Number: | POD000713 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | GA |
Taxonomy Type: | Podiatric Medicine & Surgery Service Providers |
Taxonomy Classification: | Podiatrist |
Taxonomy Specialization: | Foot & Ankle Surgery |
Taxonomy Definition: |