Individual
MARK A STANDLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
2200 W 21ST ST, SAME DAY CARE CLINIC - CLOVIS, CLOVIS, NM 88101-2011
(505) 769-7577
(505) 769-6374
Mailing address
PO BOX 26666, PHS PROVIDER ENROLLMENT, ALBUQUERQUE, NM 87125-6666
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA2018-0080
NM
Other
Enumeration date
09/06/2017
Last updated
04/08/2025
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