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Individual

MR. MARK EDWARD WILBUR

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PAC

Contact information

Practice address
700 NORTH SPRING, CALIENTE, NV 89008-1010
(775) 726-3121
(775) 726-3666
Mailing address
PO BOX 1010, 700 NORTH SPRING, CALIENTE, NV 89008-1010
(775) 726-3121
(775) 726-3666

Taxonomy

Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PA854
NV

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
100506761
NV
Enumeration date
11/17/2006
Last updated
01/23/2020
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