Individual
DR. MARK EVAN DEMUTH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
619 W MAIN ST, CLARKSON, KY 42726-7044
(186) 665-3823
Mailing address
1342 AMANDAJO DR, ELIZABETHTOWN, KY 42701-4629
(270) 307-1114
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
03097
KY
207Q00000X
Family Medicine Physician
036110355
IL
Other
Enumeration date
12/20/2006
Last updated
03/09/2009
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