Provider Demographics
NPI:1043240641
Name:VERNON, MARK STEVEN (MD)
Entity Type:Individual
Prefix:DR
First Name:MARK
Middle Name:STEVEN
Last Name:VERNON
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:6950 E WILLIAMS FIELD RD
Mailing Address - Street 2:
Mailing Address - City:MESA
Mailing Address - State:AZ
Mailing Address - Zip Code:85212-6033
Mailing Address - Country:US
Mailing Address - Phone:602-277-5551
Mailing Address - Fax:602-222-6496
Practice Address - Street 1:6950 E WILLIAMS FIELD RD
Practice Address - Street 2:
Practice Address - City:MESA
Practice Address - State:AZ
Practice Address - Zip Code:85212-6033
Practice Address - Country:US
Practice Address - Phone:602-277-5551
Practice Address - Fax:602-222-6496
Is Sole Proprietor?:No
Enumeration Date:2006-07-03
Last Update Date:2010-12-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
AZAZ 22357207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine