Organization
MARK L WESTPHAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARK L WESTPHAL MD (PRESIDENT)
(618) 549-0841
Entity
Organization
Contact information
Practice address
665 E LAKE RD, CARBONDALE, IL 62901-5347
(618) 549-0841
(618) 529-2442
Mailing address
PO BOX 399, CARBONDALE, IL 62903-0399
(618) 549-0841
(618) 529-2442
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
—
—
Other
Enumeration date
03/12/2024
Last updated
03/12/2024
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