Individual
MR. MARK ANDREW WATERMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
1200 E PECAN ST, ALTUS, OK 73521-6141
(580) 379-5860
Mailing address
1200 E PECAN ST, ALTUS, OK 73521-6141
(580) 379-5860
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
96660
OK
Other
Enumeration date
09/09/2009
Last updated
09/09/2009
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