Individual
DR. MARK ALLEN WALLINGFORD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2009 OLD MAIN STREET, MAYSVILLE, KY 41056
(606) 759-7615
(606) 759-7821
Mailing address
2009 OLD MAIN STREET, MAYSVILLE, KY 41056
(606) 759-7615
(606) 759-7821
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
24430
KY
208000000X
Pediatrics Physician
24430
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
64244304
—
KY
Enumeration date
10/24/2006
Last updated
01/30/2017
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