Provider Demographics
NPI:1336299577
Name:ALBERS, MARK L
Entity Type:Individual
Prefix:DR
First Name:MARK
Middle Name:L
Last Name:ALBERS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8100 E 22ND ST N
Mailing Address - Street 2:BUILDING 1600B
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67226-2316
Mailing Address - Country:US
Mailing Address - Phone:316-686-2626
Mailing Address - Fax:316-686-2146
Practice Address - Street 1:8100 E 22ND ST N
Practice Address - Street 2:BUILDING 1600B
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67226-2316
Practice Address - Country:US
Practice Address - Phone:316-686-2626
Practice Address - Fax:316-686-2146
Is Sole Proprietor?:No
Enumeration Date:2007-01-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS3881111N00000X
MO5507111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS060987OtherBLUE CROSS
KS660044Medicare ID - Type Unspecified