Provider Demographics
NPI:1306849658
Name:MARKS, STUART D (MD)
Entity Type:Individual
Prefix:DR
First Name:STUART
Middle Name:D
Last Name:MARKS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:905 STEVENS CREEK RD
Mailing Address - Street 2:
Mailing Address - City:AUGUSTA
Mailing Address - State:GA
Mailing Address - Zip Code:30907-3201
Mailing Address - Country:US
Mailing Address - Phone:706-922-6000
Mailing Address - Fax:706-722-7994
Practice Address - Street 1:905 STEVENS CREEK RD
Practice Address - Street 2:
Practice Address - City:AUGUSTA
Practice Address - State:GA
Practice Address - Zip Code:30907-3201
Practice Address - Country:US
Practice Address - Phone:706-922-6000
Practice Address - Fax:706-722-7994
Is Sole Proprietor?:No
Enumeration Date:2005-05-31
Last Update Date:2007-12-07
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
GAGA30348207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA00357618BMedicaid
SCGPA 573Medicaid
GA18BDBGHMedicare ID - Type UnspecifiedINDIVIDUAL MEDICARE
GA00357618BMedicaid