Bedard, Mark D
Bedard, Mark D is an individual health care provider with primary practice located at 2140 Smith St Credentialing Department, Orange Park FL 32073-5554. He recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatrics, which is considered as his primary health care specialty. Bedard, Mark D can be contacted via phone (904) 269-2140.Contact Information
Primary practice address
2140 Smith St Credentialing Department
Orange Park FL 32073-5554
Phone: (904) 269-2140
Fax: (904) 264-3018
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Pediatrics | 208000000X | OS 12071 | Florida |
Profile Details
| NPI number | 1154649861 |
|---|---|
| LBN Legal business name | Bedard, Mark D |
| Credentials | Doctor of Osteopathy (DO) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | May 6th, 2010 |
| Last updated | Dec 24th, 2018 - about 6 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1154649861 | NPPES |
| Florida | MEDICAID | 008887400 |
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