Provider Demographics
NPI:1255605069
Name:HERRON, MARK P (PA-C)
Entity type:Individual
Prefix:
First Name:MARK
Middle Name:P
Last Name:HERRON
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Gender:M
Credentials:PA-C
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Mailing Address - Street 1:4 CRESCENT ST.
Mailing Address - Street 2:
Mailing Address - City:PENACOOK
Mailing Address - State:NH
Mailing Address - Zip Code:03303-1412
Mailing Address - Country:US
Mailing Address - Phone:603-753-4302
Mailing Address - Fax:603-227-7570
Practice Address - Street 1:4 CRESCENT ST
Practice Address - Street 2:
Practice Address - City:PENACOOK
Practice Address - State:NH
Practice Address - Zip Code:03303-1412
Practice Address - Country:US
Practice Address - Phone:603-753-4302
Practice Address - Fax:603-227-7570
Is Sole Proprietor?:No
Enumeration Date:2012-02-27
Last Update Date:2021-03-19
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant