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MR. MARK TIMOTHY SIZEMORE IDC

Independent Duty Corpsman >> Military Health Care Provider >> Other Service Providers

Registrant NPI Number: 1669409215

Individual Registrant:
MR. MARK TIMOTHY SIZEMORE IDC
Gender: M
Not Sole Proprietor

Location and contact information for practice:
NAVAL BRANCH HEALTH CLINIC 881 USS JAMES MADISON RD. KINGS BAY, GA 31547-2531 US
Tel: 912-573-2618  Fax: --

Contact information for business:
132 LAKE WELLINGTON DR  KINGSLAND, GA 31548-5702 US
Tel: 912-576-8902  Fax: --

Registration Information:
NPI: 1669409215
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y1710I1002XOther Service Providers
Military Health Care Provider
Independent Duty Corpsman

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType




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