Condon, Mark A

Condon, Mark A is an sole proprietor health care provider with primary practice located at 294 E Layfair Dr , Flowood MS 39232-9526. He recently has only one registered license in Allopathic & Osteopathic Physicians / Urology, which is considered as his primary health care specialty. Condon, Mark A can be contacted via phone (601) 936-4645.

Contact Information

Primary practice address
294 E Layfair Dr Flowood MS 39232-9526
Fax:
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Urology 208800000X 13590 Mississippi

Profile Details

NPI number 1255419263
LBN Legal business name Condon, Mark A
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Nov 1st, 2006
Last updated Mar 13th, 2014 - about 10 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 1255419263 NPPES
Mississippi MEDICAID 00119423

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