Sorensen, Mark Jacob

Sorensen, Mark Jacob is an sole proprietor health care provider with primary practice located at 75 Claremont St Suite B, Kalispell MT 59901-3585. He recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatrics, which is considered as his primary health care specialty. Sorensen, Mark Jacob can be contacted via phone (406) 752-2277.

Contact Information

Primary practice address
75 Claremont St Suite B Kalispell MT 59901-3585
Phone: (406) 752-2277
Fax: (406) 752-5029
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatrics 208000000X 4265 Montana

Profile Details

NPI number 1841219193
LBN Legal business name Sorensen, Mark Jacob
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jul 18th, 2006
Last updated Jul 8th, 2007 - about 19 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 1841219193 NPPES
Montana Other 810375497 59901 A001 TRICARE
Montana MEDICAID 0050882 TRICARE
Montana Other 12270 TRICARE

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