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Individual

MARK A MARNER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
804 KENYON RD, SUITE D, FORT DODGE, IA 50501-5742
(515) 574-6141
(515) 574-6145
Mailing address
804 KENYON RD, SUITE D, FORT DODGE, IA 50501-5742
(515) 574-6141
(515) 574-6145

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
21152
IA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0006577
IA
01
110046473
RR MEDICARE
IA
01
18160
BC/BS
IA
Enumeration date
02/06/2006
Last updated
12/16/2009
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