Individual
MARK D TEETER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2910 JENNY LIND, BLDG #12, FORT SMITH, AR 72901-6735
(479) 785-2555
(479) 785-3555
Mailing address
PO BOX 2610, FORT SMITH, AR 72902-2610
(479) 785-2555
(479) 785-3555
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
C7545
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
10071550A
—
OK
Enumeration date
09/01/2006
Last updated
07/08/2007
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