George, Mark A.
George, Mark A. is an individual health care provider with primary practice located at 22640 Se Stark St , Gresham OR 97030-2656. He recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as his primary health care specialty. George, Mark A. can be contacted via phone (503) 667-0441.Contact Information
Primary practice address
22640 Se Stark St
Gresham OR 97030-2656
Phone: (503) 667-0441
Fax: (503) 666-6718
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Eye and Vision Services Providers / Optometrist | 152W00000X | 2098T | Oregon |
Profile Details
| NPI number | 1942228648 |
|---|---|
| LBN Legal business name | George, Mark A. |
| Credentials | Doctor of Optometry (OD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jul 18th, 2006 |
| Last updated | Jan 25th, 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 | 1942228648 | NPPES |
| Oregon | MEDICAID | 044222 |
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