Individual
MARK LEON SIEBE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
BLANCHFIELD ARMY COMMUNITY HOSPITAL, 650 JOEL DR, FORT CAMPBELL, KY 42223-5318
(270) 798-8727
Mailing address
1046 WESTON CT, BRENTWOOD, TN 37027-2404
(615) 630-2250
(615) 630-2250
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
3649
TN
363A00000X
Physician Assistant
—
—
Other
Enumeration date
05/17/2018
Last updated
08/28/2020
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