Agpoon, Mark

Agpoon, Mark is an individual health care provider with primary practice located at 3314 N 124Th St W , Wichita KS 67223-6909. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered, which is considered as his primary health care specialty. Agpoon, Mark can be contacted via phone (316) 722-8049.

Contact Information

Primary practice address
3314 N 124Th St W Wichita KS 67223-6909
Phone: (316) 722-8049
Fax: (316) 722-8049
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered 367500000X 55429 Kansas

Profile Details

NPI number 1023098548
LBN Legal business name Agpoon, Mark
Credentials Certified Registered Nurse Anesthetist (CRNA)
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 19th, 2006
Last updated Aug 24th, 2009 - about 16 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1023098548 NPPES
Kansas MEDICAID 200331110G

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