Dobbertien, Mark Alan
Dobbertien, Mark Alan is an individual health care provider with primary practice located at 655 W 8Th St Ufjp Surgery Department, Jacksonville FL 32209-6511. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Emergency Medicine, Allopathic & Osteopathic Physicians / Surgery. Allopathic & Osteopathic Physicians / Surgery is his primary health care specialty. Dobbertien, Mark Alan can be contacted via phone (904) 383-1015.Contact Information
Primary practice address
655 W 8Th St Ufjp Surgery Department
Jacksonville FL 32209-6511
Phone: (904) 383-1015
Fax: (904) 244-6252
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Emergency Medicine | 207P00000X | OS 6627 | Florida |
| Allopathic & Osteopathic Physicians / Surgery | 208600000X | OS 6627 | Florida |
Profile Details
| NPI number | 1265407043 |
|---|---|
| LBN Legal business name | Dobbertien, Mark Alan |
| Credentials | Doctor of Osteopathy (DO) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Feb 23rd, 2006 |
| Last updated | Jan 11th, 2011 - about 13 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 | 1265407043 | NPPES |
| Florida | Other | 930071111 | RR MEDICARE |
| Florida | MEDICAID | 3738060-00 | RR MEDICARE |
| Florida | MEDICAID | 00744004A | RR MEDICARE |
| Florida | MEDICAID | 2748282-00 | RR MEDICARE |
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