Short, Mark S

Short, Mark S is an individual health care provider with primary practice located at 126 Missouri Ave Mcxp-Ccs-Cr, Fort Leonard Wood MO 65473-8952. 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. Short, Mark S can be contacted via phone (573) 596-0417.

Contact Information

Primary practice address
126 Missouri Ave Mcxp-Ccs-Cr Fort Leonard Wood MO 65473-8952
Phone: (573) 596-0417
Fax: (573) 596-0524
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X 2011012296 Missouri

Profile Details

NPI number 1194748863
LBN Legal business name Short, Mark S
Credentials Physician's Assistant Certified (PA-C)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 25th, 2006
Last updated May 6th, 2021 - about 4 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.

Request for update

Popular Providers