Provider Demographics
NPI:1881771079
Name:RASMUSSEN, MARK ALAN (OD)
Entity type:Individual
Prefix:DR
First Name:MARK
Middle Name:ALAN
Last Name:RASMUSSEN
Suffix:
Gender:M
Credentials:OD
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Mailing Address - Street 1:1460 S SAINT FRANCIS DR
Mailing Address - Street 2:1460 S SAINT FRANCIS DR
Mailing Address - City:SANTA FE
Mailing Address - State:NM
Mailing Address - Zip Code:87505-4038
Mailing Address - Country:US
Mailing Address - Phone:505-983-7746
Mailing Address - Fax:505-983-6849
Practice Address - Street 1:1460 S SAINT FRANCIS DR
Practice Address - Street 2:1460 S SAINT FRANCIS DR
Practice Address - City:SANTA FE
Practice Address - State:NM
Practice Address - Zip Code:87505-4038
Practice Address - Country:US
Practice Address - Phone:505-983-7746
Practice Address - Fax:505-983-6849
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-01
Last Update Date:2012-08-27
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Provider Licenses
StateLicense IDTaxonomies
NM371152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist