Provider Demographics
NPI:1235392242
Name:POZAR, JOHN MARK (MD)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:MARK
Last Name:POZAR
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 12444
Mailing Address - Street 2:998 CAPITOL ST., NE
Mailing Address - City:SALEM
Mailing Address - State:OR
Mailing Address - Zip Code:97309-0444
Mailing Address - Country:US
Mailing Address - Phone:503-569-0756
Mailing Address - Fax:
Practice Address - Street 1:998 CAPITOL ST NE
Practice Address - Street 2:
Practice Address - City:SALEM
Practice Address - State:OR
Practice Address - Zip Code:97301-1201
Practice Address - Country:US
Practice Address - Phone:503-569-0756
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-09
Last Update Date:2008-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORMD08211208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice