Individual
MR. MARK MITCHELL GARSKOF
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2963 W WHITE MOUNTAIN BLVD, LAKESIDE, AZ 85929-6257
(928) 368-0765
(928) 368-4540
Mailing address
2963 W WHITE MOUNTAIN BLVD, LAKESIDE, AZ 85929-6257
(928) 368-0765
(928) 368-4540
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
10885
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200262
—
AZ
01
—
AZ0389120
BCBS
AZ
Enumeration date
11/28/2005
Last updated
03/17/2015
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