Individual
DR. MARK LEE GUISTI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
2363 N 5TH ST, STE 106, ELKO, NV 89801-4593
(775) 738-3508
(775) 738-4618
Mailing address
2363 N 5TH ST, STE 106, ELKO, NV 89801-4593
(775) 738-3508
(775) 738-4618
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
0700004503
NV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
002504510
—
NV
01
—
0805550001
CIGNA MEDICARE DMERC REGI
NV
01
—
410026356
RAILROAD MEDICARE
NV
Enumeration date
06/20/2006
Last updated
08/11/2010
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