Individual
MARK O SIMON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1650 COWLES ST, FAIRBANKS, AK 99701-5925
(907) 458-5556
Mailing address
PO BOX 70087, FAIRBANKS, AK 99707-0087
(907) 460-6667
Taxonomy
Speciality
Code
Description
License number
State
207PE0004X
Emergency Medical Services (Emergency Medicine) Physician
Primary
4813
AK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
MD2451
—
AK
Enumeration date
09/30/2005
Last updated
07/08/2007
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