Fossey, Mark Douglas

Fossey, Mark Douglas is an individual health care provider with primary practice located at 1011 Honor Heights Dr Jack C. Montgomery Vamc, Muskogee OK 74401-1318. He recently has only one registered license in Allopathic & Osteopathic Physicians / Psychiatry, which is considered as his primary health care specialty. Fossey, Mark Douglas can be contacted via phone (918) 577-3031.

Contact Information

Primary practice address
1011 Honor Heights Dr Jack C. Montgomery Vamc Muskogee OK 74401-1318
Phone: (918) 577-3031
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Psychiatry 2084P0800X 11793 Oklahoma

Profile Details

NPI number 1083684476
LBN Legal business name Fossey, Mark Douglas
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 26th, 2006
Last updated Mar 20th, 2017 - about 8 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 1083684476 NPPES
Oklahoma MEDICAID 100118230A

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