Individual
MARK T EGGLESTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
M8239
ID
207W00000X
Ophthalmology Physician
Primary
MD00039323
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0000100033114
FEDERAL BLUE CROSS
—
01
—
000010033114
REGENCE BLUE SHIELD OF IDAHO
ID
01
—
000010145029
REGENCE BLUE SHIELD OF IDAHO
ID
01
—
0152789
LABOR & INDUSTRY
WA
01
—
24509
GROUP HEALTH COOPERATIVE
WA
01
—
42663
BLUE CROSS OF IDAHO
ID
05
—
806011100
—
ID
05
—
8293425
—
WA
01
—
8928983
CRIME VICTIMES COMPENSATION ACT
WA
01
—
BYHD5
BLUE CROSS OF IDAHO
ID
01
—
MXXPR0054708
MOLINA HEALTHCARE
WA
Enumeration date
10/26/2005
Last updated
04/30/2008
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