Provider Demographics
NPI:1740289222
Name:CAYLOR, MARK T (MD)
Entity type:Individual
Prefix:
First Name:MARK
Middle Name:T
Last Name:CAYLOR
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:4015 LAKE OTIS PKWY STE 201
Mailing Address - Street 2:
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99508-5235
Mailing Address - Country:US
Mailing Address - Phone:907-771-3500
Mailing Address - Fax:907-771-3550
Practice Address - Street 1:4100 LAKE OTIS
Practice Address - Street 2:SUITE 308
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99508
Practice Address - Country:US
Practice Address - Phone:907-563-2663
Practice Address - Fax:907-333-2948
Is Sole Proprietor?:No
Enumeration Date:2005-07-18
Last Update Date:2022-01-11
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
AK6132207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
5344480OtherAETNA
AL59167304OtherBCBS
AK207X00000XOtherTAXONOMY CODE
AK1011968Medicaid
FL13007OtherBCBS
AL009918765Medicaid
FL264484300Medicaid
AL009918765Medicaid