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Individual

DR. MARK ANTHONY HUMPHREY

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
D.O.

Contact information

Practice address
110 W UTICA ST, OSWEGO, NY 13126-3057
(315) 342-2024
(315) 343-5317
Mailing address
110 W 6TH ST, OSWEGO, NY 13126-2507
(315) 349-5511
(315) 349-5921

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
208644
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
01982154
NY
Enumeration date
06/27/2006
Last updated
03/29/2023
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