Wightman, Mark Austin

Wightman, Mark Austin is an individual health care provider with primary practice located at 108 Calle Paula , Santa Fe NM 87505-5707. He recently has only one registered license in Allopathic & Osteopathic Physicians / Anesthesiology, which is considered as his primary health care specialty. Wightman, Mark Austin can be contacted via phone (505) 988-1055.

Contact Information

Primary practice address
108 Calle Paula Santa Fe NM 87505-5707
Fax:
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Anesthesiology 207L00000X 75271 New Mexico

Profile Details

NPI number 1811107063
LBN Legal business name Wightman, Mark Austin
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date May 23rd, 2007
Last updated Jul 8th, 2007 - 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 1811107063 NPPES
New Mexico Other 75271 NM MEDICAL LICENSE

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