Individual
MARK P ILTIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
619 5TH STREET, DURANT, IA 52747
(563) 785-4487
(563) 785-6681
Mailing address
865 LINCOLN RD, STE L10, BETTENDORF, IA 52722-4190
(563) 355-9191
(563) 355-3419
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
27823
IA
Other
Enumeration date
10/07/2005
Last updated
05/27/2021
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