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Individual

MARK D MELLINGER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
1840 N JASPER DR STE 2, FLAGSTAFF, AZ 86001-1634
(866) 974-2673
(866) 939-2673
Mailing address
2208 N FREMONT BLVD, FLAGSTAFF, AZ 86001-0957
(928) 774-7757

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
31185
AZ
207X00000X
Orthopaedic Surgery Physician
31185
AZ
207X00000X
Orthopaedic Surgery Physician
33479
AZ
207XS0106X
Orthopaedic Hand Surgery Physician
Primary
31185
AZ
207XS0106X
Orthopaedic Hand Surgery Physician
33479
AZ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
766446
AZ
Enumeration date
02/01/2006
Last updated
08/08/2025
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