Riley, Mark O

Riley, Mark O is an individual health care provider with primary practice located at 720 Lindsay Ln Ste C, Cody WY 82414-4103. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, which is considered as his primary health care specialty. Riley, Mark O can be contacted via phone (307) 578-1955.

Contact Information

Primary practice address
720 Lindsay Ln Ste C Cody WY 82414-4103
Phone: (307) 578-1955
Fax: (307) 578-1957
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X 140 Wyoming

Profile Details

NPI number 1134220783
LBN Legal business name Riley, Mark O
Credentials Physician's Assistant Certified (PA-C)
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 26th, 2006
Last updated Oct 7th, 2008 - about 17 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 1134220783 NPPES
Wyoming Other 315013 BLUE CROSS BLUE SHIELD
Wyoming Other 753143209 BLUE CROSS BLUE SHIELD
Wyoming Other 612315900 BLUE CROSS BLUE SHIELD

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