Individual
MARK B TITCOMB
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
1775 THOMPSON RD, COOS BAY, OR 97420-2125
(541) 269-8020
Mailing address
1860 VIRGINIA AVE STE 9, PO BOX 349, NORTH BEND, OR 97459-2355
(541) 756-2070
(541) 756-1999
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
—
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
274528
—
OR
Enumeration date
12/06/2007
Last updated
12/06/2007
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