Individual
DR. MARK DENTON ERVIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1100 WILFORD HALL LOOP, SAN ANTONIO, TX 78236
(618) 741-6883
Mailing address
127 MULRY DR, NICEVILLE, FL 32578-2398
(850) 685-5173
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
043605
GA
Other
Enumeration date
02/21/2006
Last updated
09/11/2019
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