Wyse, Mark A
Wyse, Mark A is an individual health care provider with primary practice located at 4600 E Shea Blvd Ste 100 , Phoenix AZ 85028-6031. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Wyse, Mark A can be contacted via phone (602) 955-8700.Contact Information
Primary practice address
4600 E Shea Blvd Ste 100
Phoenix AZ 85028-6031
Phone: (602) 955-8700
Fax: (602) 553-8142
Website:
Health care specialties
Specialty | Code | License # | State |
---|---|---|---|
Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | 12165 | Arizona |
Profile Details
NPI number | 1346200060 |
---|---|
LBN Legal business name | Wyse, Mark A |
Credentials | Doctor of Medicine (MD) |
Entity | Individual |
Sole proprietor 1 | No |
Enumeration date | Mar 25th, 2006 |
Last updated | Mar 29th, 2024 - about last year |
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.
Identifiers
State | Type | Number | Issuer |
---|---|---|---|
All States | NPI | 1346200060 | NPPES |
Arizona | Other | 12165 | LICENSE |
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