Provider Demographics
NPI:1568955920
Name:STARK, AUSTIN CRAIG (MD)
Entity Type:Individual
Prefix:DR
First Name:AUSTIN
Middle Name:CRAIG
Last Name:STARK
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:12109 COUNTY ROAD 103
Mailing Address - Street 2:
Mailing Address - City:OXFORD
Mailing Address - State:FL
Mailing Address - Zip Code:34484-2951
Mailing Address - Country:US
Mailing Address - Phone:352-504-4623
Mailing Address - Fax:
Practice Address - Street 1:1840 MEASE DR STE 300
Practice Address - Street 2:
Practice Address - City:SAFETY HARBOR
Practice Address - State:FL
Practice Address - Zip Code:34695-6605
Practice Address - Country:US
Practice Address - Phone:727-785-6011
Practice Address - Fax:877-331-6124
Is Sole Proprietor?:Yes
Enumeration Date:2018-06-11
Last Update Date:2023-07-24
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLME162782208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology