Individual
DR. MARK A BACKUS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2239 NE DOCTORS DR STE 200, BEND, OR 97701-7185
(541) 318-0124
(541) 318-0188
Mailing address
2239 NE DOCTORS DR, STE 200, BEND, OR 97701-7185
(541) 318-0124
(541) 318-0182
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
MD22701
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
288094
—
OR
Enumeration date
07/03/2006
Last updated
02/20/2020
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