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Individual

MARK JAMES JAMESON

Active
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Individual

MARK JAMES JAMESON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD PHD

Taxonomy

Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
0101241309
VA
207Y00000X
Otolaryngology Physician
Primary
13192
SD

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0487819
IA
05
1073564993
VA
01
20003
WELLMARK BCBS
IA
01
P00347197
MEDICARE RAILROAD
IA
Enumeration date
05/15/2006
Last updated
02/01/2022
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