Criswell, Mark A

Criswell, Mark A is an individual health care provider with primary practice located at 307 Boatner Rd Ste 114 , Eglin Afb FL 32542. He recently has 3 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Otolaryngology, Allopathic & Osteopathic Physicians / Sleep Medicine, Allopathic & Osteopathic Physicians / Plastic Surgery within the Head & Neck. Allopathic & Osteopathic Physicians / Otolaryngology is his primary health care specialty. Criswell, Mark A can be contacted via phone (850) 883-8264.

Contact Information

Primary practice address
307 Boatner Rd Ste 114 Eglin Afb FL 32542
Phone: (850) 883-8264
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Otolaryngology 207Y00000X 01046367A Indiana
Allopathic & Osteopathic Physicians / Sleep Medicine 207YS0012X 01046367A Indiana
Allopathic & Osteopathic Physicians / Plastic Surgery within the Head & Neck 207YX0007X 0056111 Colorado
Allopathic & Osteopathic Physicians / Otolaryngology 207Y00000X 00056111 Colorado

Profile Details

NPI number 1619947033
LBN Legal business name Criswell, Mark A
Credentials M.D., F.A.C.S.
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 26th, 2006
Last updated Jul 11th, 2018 - about 7 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 1619947033 NPPES
Colorado MEDICAID 21400253
Colorado Other 027034

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