Individual
DR. MARK JACOB SORENSEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
75 CLAREMONT ST, SUITE B, KALISPELL, MT 59901-3585
(406) 752-2277
(406) 752-5029
Mailing address
75 CLAREMONT ST, SUITE B, KALISPELL, MT 59901-3585
(406) 752-2277
(406) 752-5029
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
4265
MT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0050882
—
MT
01
—
12270
BLUE CROSS OF MONTANA
MT
01
—
810375497 59901 A001
TRICARE
MT
Enumeration date
07/18/2006
Last updated
07/08/2007
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