Provider Demographics
NPI:1457312480
Name:TOWNS, MARK D (MD)
Entity Type:Individual
Prefix:MR
First Name:MARK
Middle Name:D
Last Name:TOWNS
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:4521 JOE WILSON RD
Mailing Address - Street 2:
Mailing Address - City:MIDLOTHIAN
Mailing Address - State:TX
Mailing Address - Zip Code:76065-4565
Mailing Address - Country:US
Mailing Address - Phone:972-723-5678
Mailing Address - Fax:
Practice Address - Street 1:2828 DUKE OF GLOUCESTER ST
Practice Address - Street 2:SUITE 106
Practice Address - City:DESOTO
Practice Address - State:TX
Practice Address - Zip Code:75115-2067
Practice Address - Country:US
Practice Address - Phone:972-298-3888
Practice Address - Fax:972-296-0838
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-03-29
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
TXG5700208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXC22738Medicare UPIN