Provider Demographics
NPI:1003901190
Name:NAISBITT, MARK S (MD, PC)
Entity Type:Individual
Prefix:
First Name:MARK
Middle Name:S
Last Name:NAISBITT
Suffix:
Gender:M
Credentials:MD, PC
Other - Prefix:
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Mailing Address - Street 1:3340 NORTH CENTER ST
Mailing Address - Street 2:#800
Mailing Address - City:LEHI
Mailing Address - State:UT
Mailing Address - Zip Code:84043-7406
Mailing Address - Country:US
Mailing Address - Phone:801-990-1911
Mailing Address - Fax:801-392-1461
Practice Address - Street 1:4401 HARRISON BOULEVARD
Practice Address - Street 2:MCKAY DEE HOSPITAL
Practice Address - City:OGDEN
Practice Address - State:UT
Practice Address - Zip Code:84403
Practice Address - Country:US
Practice Address - Phone:801-507-5248
Practice Address - Fax:801-733-5618
Is Sole Proprietor?:No
Enumeration Date:2006-10-04
Last Update Date:2012-10-15
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
UT91-184191-1205207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
UT37807OtherPEHP
UT53257OtherHEALTHY U
UT1502954OtherUMWA
UTQM0000075886OtherALTIUS
AZ822107Medicaid
UT8597445OtherWORKERS COMP
ID804100900Medicaid
UTPRA06691OtherMOLINA
UT20167OtherDESERET MUTUAL
UT2090168OtherUNITED HEALTHCARE
WY104856200Medicaid
UT107005583101OtherIHC
UT870545614NA1OtherEDUCATORS MUTUAL
NV100501270Medicaid
UT870545614NA1OtherEDUCATORS MUTUAL
UT107005583101OtherIHC
UT1502954OtherUMWA