Individual
MARK ALLEN SIEBRECHT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.P.M.
Contact information
Practice address
255 W. LUCAS ST., MARENGO, IA 52301
(319) 741-6789
(319) 741-6791
Mailing address
255 W LUCAS ST, MARENGO, IA 52301-1331
(319) 741-6789
(319) 741-6791
Taxonomy
Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
00701
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2221713
—
IA
01
—
35111
WELLMARK PROVIDER NUMBER
IA
Enumeration date
10/20/2005
Last updated
09/23/2013
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