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Individual

MR. MARK ALEXANDER AZEL

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PA-C

Contact information

Practice address
46TH ENGINEER COMBAT BATTALION, BLDG. 2264, SUITE 105, FORT POLK, LA 71459
(337) 531-4233
Mailing address
16314 MORAN PL APT A, FORT POLK, LA 71459-2576
(337) 537-8979

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
1052506

Other

Enumeration date
12/28/2006
Last updated
07/08/2007
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