Organization
MARK B. WALL, MD PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARK BURNETTE WALL MD (PRESIDENT-OWNER)
(228) 875-0693
Entity
Organization
Contact information
Practice address
150 REYNOIR ST, BILOXI, MS 39530-4130
(228) 432-1571
Mailing address
202 WASHINGTON AVE, OCEAN SPRINGS, MS 39564-4626
(228) 875-0693
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
—
—
Other
Enumeration date
03/01/2016
Last updated
03/01/2016
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