Provider Demographics
NPI:1376788521
Name:MINTON, MARK DANIEL (PA-C)
Entity type:Individual
Prefix:MR
First Name:MARK
Middle Name:DANIEL
Last Name:MINTON
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Gender:M
Credentials:PA-C
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Mailing Address - Street 1:PO BOX 746450
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30374-6450
Mailing Address - Country:US
Mailing Address - Phone:251-470-5842
Mailing Address - Fax:318-868-6430
Practice Address - Street 1:2451 UNIVERSITY HOSPITAL DR
Practice Address - Street 2:
Practice Address - City:MOBILE
Practice Address - State:AL
Practice Address - Zip Code:36617-2300
Practice Address - Country:US
Practice Address - Phone:251-471-7000
Practice Address - Fax:251-471-7096
Is Sole Proprietor?:No
Enumeration Date:2008-12-02
Last Update Date:2025-02-07
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Provider Licenses
StateLicense IDTaxonomies
ALPA-621363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant