Provider Demographics
NPI:1093803017
Name:APPEL, MARK ELLIOTT (OD)
Entity Type:Individual
Prefix:DR
First Name:MARK
Middle Name:ELLIOTT
Last Name:APPEL
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
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Mailing Address - Street 1:105 DEWBERRY DR
Mailing Address - Street 2:
Mailing Address - City:NEW MARKET
Mailing Address - State:AL
Mailing Address - Zip Code:35761-9283
Mailing Address - Country:US
Mailing Address - Phone:256-650-0045
Mailing Address - Fax:256-883-3008
Practice Address - Street 1:3007 MEMORIAL PKWY SW
Practice Address - Street 2:
Practice Address - City:HUNTSVILLE
Practice Address - State:AL
Practice Address - Zip Code:35801-5393
Practice Address - Country:US
Practice Address - Phone:256-650-0045
Practice Address - Fax:256-883-3008
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALS-661-TA-329152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist