Individual
DR. MARK C. HURST
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
OPTOMETRIST, LTD.
Contact information
Practice address
4 WESTWOOD DRIVE, MT VERNON, IL 62864
(618) 242-7810
(618) 242-1867
Mailing address
4 WESTWOOD DRIVE, MT VERNON, IL 62864
(618) 242-7810
(618) 242-1867
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
046007393
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0622930001
ADMINASTAR FEDERAL
—
01
—
1851561575
JURISDICTION B DME MAC
—
01
—
410046689
RR MEDICARE
—
Enumeration date
02/02/2006
Last updated
06/16/2008
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