Individual
MARK RICHARD HISKES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPM
Contact information
Practice address
69 E GARNER RD, STE 100, BROWNSBURG, IN 46112-7699
(317) 852-7511
(317) 852-7531
Mailing address
69 E GARNER RD, STE 100, BROWNSBURG, IN 46112-7699
(317) 852-7511
(317) 852-7531
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
07000693
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100119070
—
IN
01
—
1033312020
DME
IN
Enumeration date
06/28/2005
Last updated
11/22/2011
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