# MARK T CALLESEN MD PC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1588727259
- **Authorized official:** DR. MARK TRAVIS CALLESEN M.D. (PRESIDENT)
- **Authorized official phone:** (480) 464-4606

## Contact information

- **Practice address:** 1201 S ALMA SCHOOL RD, SUITE 11750, MESA, AZ 85210-2008
- **Practice address phone:** (480) 464-4606
- **Practice address fax:** (480) 464-0613
- **Mailing address:** 1201 S ALMA SCHOOL RD, SUITE 11750, MESA, AZ 85210-2008
- **Mailing address phone:** (480) 464-4606
- **Mailing address fax:** (480) 464-0613

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 323P00000X | Psychiatric Residential Treatment Facility | 23058 | AZ | Yes |

## Other

- **Enumeration date:** 12/17/2006
- **Last updated:** 08/22/2020