Individual
MARK ALAN MIDTHUN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3626 EAST AVE S STE 2A, LA CROSSE, WI 54601-7221
(608) 787-6411
(608) 787-6414
Mailing address
W6602 SCHILLING RD, UNIT C, ONALASKA, WI 54650-9341
(608) 397-5904
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
3717
SD
2084P0800X
Psychiatry Physician
49571
MN
2084P0800X
Psychiatry Physician
Primary
50549-020
WI
Other
Enumeration date
11/29/2006
Last updated
03/30/2020
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