Individual
DR. MARK A ROSALES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
100 HIGHWAY 28 E, BELLE, MO 65013-3405
(573) 859-3775
(573) 859-3997
Mailing address
PO BOX 1027, JEFFERSON CITY, MO 65102-1027
(573) 859-3775
(573) 859-3997
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
DO113794
MO
207QH0002X
Hospice and Palliative Medicine (Family Medicine) Physician
113794
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
248871204
—
MO
01
—
CC7852
RR GROUP
MO
01
—
P00325210
RAILROAD
MO
Enumeration date
06/16/2006
Last updated
09/08/2022
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