Fesen, Mark

Fesen, Mark is an individual health care provider with primary practice located at 204 Cleveland St , Great Bend KS 67530-3563. He recently has only one registered license in Allopathic & Osteopathic Physicians / Medical Oncology, which is considered as his primary health care specialty. Fesen, Mark can be contacted via phone (620) 792-5511.

Contact Information

Primary practice address
204 Cleveland St Great Bend KS 67530-3563
Phone: (620) 792-5511
Fax: (620) 792-5977
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Medical Oncology 207RX0202X 04-24425 Kansas

Profile Details

NPI number 1639149545
LBN Legal business name Fesen, Mark
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 24th, 2006
Last updated Jan 12th, 2021 - about 3 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 1639149545 NPPES
Oklahoma MEDICAID 200484450A
Oklahoma Other 016701006
Oklahoma MEDICAID 100143470N
Oklahoma MEDICAID 100143470E

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