Packer, Mark

Packer, Mark is an individual health care provider with primary practice located at 1400 Bluebell Ave , Boulder CO 80302-7834. He recently has only one registered license in Allopathic & Osteopathic Physicians / Ophthalmology, which is considered as his primary health care specialty. Packer, Mark can be contacted via phone (541) 915-0291.

Contact Information

Primary practice address
1400 Bluebell Ave Boulder CO 80302-7834
Phone: (541) 915-0291
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Ophthalmology 207W00000X MD22302 Oregon
Allopathic & Osteopathic Physicians / Ophthalmology 207W00000X 75599 California
Allopathic & Osteopathic Physicians / Ophthalmology 207W00000X DR.0054602 Colorado

Profile Details

NPI number 1205834439
LBN Legal business name Packer, Mark
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 12th, 2005
Last updated Dec 20th, 2018 - 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1205834439 NPPES
Oregon MEDICAID 130311
Oregon Other 180043385
Oregon Other 180040741

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