Obenchain, Mark Allen
Obenchain, Mark Allen is an individual health care provider with primary practice located at 5101 N. Davis Hwy Suite A, Pensacola FL 32503-2040. He recently has 2 registered licenses in different health care specialties including Eye and Vision Services Providers / Low Vision Rehabilitation, Eye and Vision Services Providers / Optometrist. Eye and Vision Services Providers / Optometrist is his primary health care specialty. Obenchain, Mark Allen can be contacted via phone (850) 479-7379.Contact Information
Primary practice address
5101 N. Davis Hwy Suite A
Pensacola FL 32503-2040
Phone: (850) 479-7379
Fax: (850) 497-6219
Website:
Health care specialties
Specialty | Code | License # | State |
---|---|---|---|
Eye and Vision Services Providers / Low Vision Rehabilitation | 152WL0500X | OPC5023 | Florida |
Eye and Vision Services Providers / Optometrist | 152W00000X | OPC5023 | Florida |
Profile Details
NPI number | 1376983874 |
---|---|
LBN Legal business name | Obenchain, Mark Allen |
Credentials | Doctor of Optometry (OD) |
Entity | Individual |
Sole proprietor 1 | No |
Enumeration date | Jun 28th, 2013 |
Last updated | Aug 7th, 2017 - about 7 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 | 1376983874 | NPPES |
Florida | Other | 190NO | FLORIDA BLUE |
Florida | MEDICAID | 014082700 | FLORIDA BLUE |
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