Provider Demographics
NPI:1477580249
Name:NEER, MARK HASTINGS (PA-C)
Entity Type:Individual
Prefix:
First Name:MARK
Middle Name:HASTINGS
Last Name:NEER
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 849
Mailing Address - Street 2:
Mailing Address - City:SHAWNEE
Mailing Address - State:OK
Mailing Address - Zip Code:74802-0849
Mailing Address - Country:US
Mailing Address - Phone:918-968-4469
Mailing Address - Fax:918-968-1618
Practice Address - Street 1:2308-B WEST HIGHWAY 66
Practice Address - Street 2:
Practice Address - City:STROUD
Practice Address - State:OK
Practice Address - Zip Code:74079-6729
Practice Address - Country:US
Practice Address - Phone:918-968-4469
Practice Address - Fax:918-968-1618
Is Sole Proprietor?:No
Enumeration Date:2006-06-27
Last Update Date:2014-02-07
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
OK1271363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical