Individual
MARK S QUINN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
320 KENNESTONE HOSPITAL BLVD, SUITE LL1, MARIETTA, GA 30060-1161
(770) 793-7500
(770) 793-7985
Mailing address
320 KENNESTONE HOSPITAL BLVD, SUITE LL1, MARIETTA, GA 30060-1161
(770) 793-7500
(770) 793-7985
Taxonomy
Speciality
Code
Description
License number
State
2085R0001X
Radiation Oncology Physician
Primary
050316
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000911325G
—
GA
05
—
000911325J
—
GA
05
—
656499202A
—
GA
05
—
656499202B
—
GA
05
—
656499202C
—
GA
05
—
656499202D
—
GA
05
—
656499202E
—
GA
05
—
656499202F
—
GA
01
—
92BBGBT
MEDICARE PROVIDER ID
GA
Enumeration date
06/03/2006
Last updated
08/30/2012
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