Bacon, Mark Robert

Bacon, Mark Robert is an individual health care provider with primary practice located at 72Nd Medical Group 5700 Arnold St, Tinker Afb OK 73145. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Medical, which is considered as his primary health care specialty. Bacon, Mark Robert can be contacted via phone (405) 736-4943.

Contact Information

Primary practice address
72Nd Medical Group 5700 Arnold St Tinker Afb OK 73145
Phone: (405) 736-4943
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Medical 363AM0700X 1389 Oklahoma
Physician Assistants & Advanced Practice Nursing Providers / Medical 363AM0700X 602 Alaska

Profile Details

NPI number 1972530053
LBN Legal business name Bacon, Mark Robert
Credentials Physician's Assistant Certified (PA-C)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 26th, 2006
Last updated Jul 8th, 2007 - about 18 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.

Request for update

Popular Providers