Provider Demographics
NPI:1528032414
Name:WERNING, MARK A (DC)
Entity Type:Individual
Prefix:DR
First Name:MARK
Middle Name:A
Last Name:WERNING
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:708 W MAIN ST
Mailing Address - Street 2:
Mailing Address - City:PARKSTON
Mailing Address - State:SD
Mailing Address - Zip Code:57366-2100
Mailing Address - Country:US
Mailing Address - Phone:605-928-3304
Mailing Address - Fax:605-928-3505
Practice Address - Street 1:708 W MAIN ST
Practice Address - Street 2:
Practice Address - City:PARKSTON
Practice Address - State:SD
Practice Address - Zip Code:57366-2100
Practice Address - Country:US
Practice Address - Phone:605-928-3304
Practice Address - Fax:605-928-3505
Is Sole Proprietor?:No
Enumeration Date:2006-02-15
Last Update Date:2007-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SD574111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
SD7600512Medicaid
SD0007971OtherBLUE CROSS BLUE SHIELD
SD22502OtherSIOUX VALLEY HEALTH PLAN
SD7600512Medicaid