Organization
J MARK PALMER, MD PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
J MARK PALMER MD PA (OWNER)
(817) 334-0686
Entity
Organization
Contact information
Practice address
800 8TH AVENUE, #426, FORT WORTH, TX 76104
(817) 334-0686
(817) 334-0689
Mailing address
800 8TH AVENUE, #426, FORT WORTH,, TX 76104
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
134819505
—
TX
Enumeration date
05/17/2012
Last updated
05/17/2012
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