Individual
EDWARD K MARK JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
4274 N VALDOSTA RD, VALDOSTA, GA 31602-6814
(229) 242-1234
(229) 247-8110
Mailing address
4274 N VALDOSTA RD, VALDOSTA, GA 31602-6814
(229) 242-1234
(229) 247-8110
Taxonomy
Speciality
Code
Description
License number
State
207T00000X
Neurological Surgery Physician
Primary
029908
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00370686D
—
GA
Enumeration date
08/31/2006
Last updated
07/08/2007
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