Wilkes, Mark S

Wilkes, Mark S is an individual health care provider with primary practice located at 250 Ne Mulberry St C/O Sjs Medical Management, Suite 202, Lees Summit MO 64086-4533. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered, which is considered as his primary health care specialty. Wilkes, Mark S can be contacted via phone (816) 389-4130.

Contact Information

Primary practice address
250 Ne Mulberry St C/O Sjs Medical Management, Suite 202 Lees Summit MO 64086-4533
Phone: (816) 389-4130
Fax: (816) 389-4140
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered 367500000X 095684 Missouri

Profile Details

NPI number 1467412254
LBN Legal business name Wilkes, Mark S
Credentials Certified Registered Nurse Anesthetist (CRNA)
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 24th, 2006
Last updated Jun 2nd, 2008 - about 16 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 1467412254 NPPES
Missouri MEDICAID 913767018

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