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Individual

DR. MARK E DAVISSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
152 WITTENBRAKER AVE, NEW CASTLE, IN 47362-5000
(765) 599-3100
(765) 518-5365
Mailing address
PO BOX 485, NEW CASTLE, IN 47362-0485
(765) 521-1516
(765) 599-3131

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
01036929
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
100135170
IN
Enumeration date
10/05/2006
Last updated
09/14/2020
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