Provider Demographics
NPI:1821045105
Name:MECIKALSKI, MARK B (MD)
Entity Type:Individual
Prefix:DR
First Name:MARK
Middle Name:B
Last Name:MECIKALSKI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:7580 N CALLE SIN DESENGANO
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85718-1264
Mailing Address - Country:US
Mailing Address - Phone:520-390-8078
Mailing Address - Fax:520-305-4304
Practice Address - Street 1:7580 N CALLE SIN DESENGANO
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85718-1264
Practice Address - Country:US
Practice Address - Phone:520-390-8078
Practice Address - Fax:520-305-4304
Is Sole Proprietor?:No
Enumeration Date:2006-05-30
Last Update Date:2023-02-16
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
AZ13945207R00000X, 207RC0200X, 207RS0012X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RS0012XAllopathic & Osteopathic PhysiciansInternal MedicineSleep Medicine
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
C99965Medicare UPIN