Eidson, Mark Carroll
Eidson, Mark Carroll is an sole proprietor health care provider with primary practice located at 710 E Anderson St Ste C, Weatherford TX 76086-5870. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Eidson, Mark Carroll can be contacted via phone (817) 599-9472.Contact Information
Primary practice address
710 E Anderson St Ste C
Weatherford TX 76086-5870
Phone: (817) 599-9472
Fax: (817) 458-0209
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | F3927 | Texas |
Profile Details
| NPI number | 1295726784 |
|---|---|
| LBN Legal business name | Eidson, Mark Carroll |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Nov 2nd, 2005 |
| Last updated | Jan 21st, 2010 - about 14 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 | 1295726784 | NPPES |
| Texas | MEDICAID | 110474702 |
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