Provider Demographics
NPI:1245320555
Name:FORD, MARK WAYNE JR (DC)
Entity type:Individual
Prefix:DR
First Name:MARK
Middle Name:WAYNE
Last Name:FORD
Suffix:JR
Gender:M
Credentials:DC
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Mailing Address - Street 1:1920 HOLLY LN
Mailing Address - Street 2:
Mailing Address - City:PAMPA
Mailing Address - State:TX
Mailing Address - Zip Code:79065-4018
Mailing Address - Country:US
Mailing Address - Phone:806-440-2362
Mailing Address - Fax:806-665-0537
Practice Address - Street 1:701 N PRICE RD
Practice Address - Street 2:
Practice Address - City:PAMPA
Practice Address - State:TX
Practice Address - Zip Code:79065-5126
Practice Address - Country:US
Practice Address - Phone:806-665-7261
Practice Address - Fax:806-665-0537
Is Sole Proprietor?:No
Enumeration Date:2006-10-15
Last Update Date:2025-02-05
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
TX4081111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
1245320555OtherNPI
TX603479OtherBLUE CROSS ID#
8F8622OtherMEDICARE #
TX603479OtherBLUE CROSS ID#