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:
Health care specialties
| Specialty | Code | License # | 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1083684476 | NPPES |
| Oklahoma | MEDICAID | 100118230A |
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