Individual
DR. MARK A WITT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPM
Contact information
Practice address
709 HOLLYBROOK DR, SUITE 3401, LONGVIEW, TX 75605-2411
(903) 753-1778
(903) 753-7202
Mailing address
PO BOX 610393, DALLAS, TX 75261-0393
(903) 232-8501
(903) 232-8226
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
1692
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
166961601
—
TX
01
—
P00442444
RR MEDICARE
TX
Enumeration date
03/03/2006
Last updated
06/13/2019
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