Vig, Mark Edward

Vig, Mark Edward is an individual health care provider with primary practice located at 520 Douglas Blvd , Tyler TX 75702-8307. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Internal Medicine, Student, Health Care / Student in an Organized Health Care Education/Training Program. Allopathic & Osteopathic Physicians / Internal Medicine is his primary health care specialty. Vig, Mark Edward can be contacted via phone (903) 593-1721.

Contact Information

Primary practice address
520 Douglas Blvd Tyler TX 75702-8307
Phone: (903) 593-1721
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X 55603 Wisconsin
Student, Health Care / Student in an Organized Health Care Education/Training Program 390200000X
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X Q8380 Texas

Profile Details

NPI number 1023251527
LBN Legal business name Vig, Mark Edward
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 13th, 2009
Last updated Jun 9th, 2017 - about 8 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 1023251527 NPPES
Texas Other 8GK658 BCBS
Texas MEDICAID 369865601 BCBS
Texas Other 75-2616977-007 BCBS

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