Individual
MR. MARK EDWARD CHOQUETTE JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
615 OZARK RD, ABBEVILLE, AL 36310-2629
(334) 585-1171
(334) 585-1182
Mailing address
1414 ELBA HWY, TROY, AL 36079-6020
(334) 670-6726
(334) 670-6731
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
PA536
AL
363AM0700X
Medical Physician Assistant
Primary
PA536
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1076470
NCCPA
—
05
—
125758
—
AL
01
—
PA536
STATE LICENSE
AL
Enumeration date
11/27/2007
Last updated
06/14/2022
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