Dr. Mark A Criswell
Otolaryngologist (ENT Doctor) Plastic Surgeon (Head & Neck)
307 Boatner Rd Ste 114
Eglin Afb
, Florida 32542
Dr. Mark A Criswell
Otolaryngologist (ENT Doctor) Plastic Surgeon (Head & Neck)
307 Boatner Rd Ste 114
Eglin Afb
, Florida 32542
(850) 883-8264
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About
Features
Specialties
- Otolaryngologist (ENT Doctor)
- Plastic Surgeon (Head & Neck)
Languages spoken
- English
Location
First Address
- Dr. Mark A Criswell
- 307 Boatner Rd Ste 114
- Eglin Afb, FL
- Zip : 32542-1302
- Phone : (850) 883-8264
Second Address
- Dr. Mark A Criswell
- 307 Boatner Rd Ste 114
- Eglin Afb, FL
- Zip : 32542
- Phone : (850) 883-8264
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 207Y00000X | Otolaryngologist (ENT Doctor) | 00056111 | CO |
| N | 207Y00000X | Otolaryngologist (ENT Doctor) | 01046367A | IN |
| N | 207YX0007X | Plastic Surgeon (Head & Neck) | 0056111 | CO |
National Provider Identifier
| NPI | 1619947033 |
|---|---|
| Provider Name | Dr. Mark A Criswell |
| First Address | Eglin Afb, FL 32542-1302 |
| Second Address | Eglin Afb, FL 32542 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 26/01/2006 |
| Last Update Date | 11/07/2018 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| 027034 | KAISER COMMERCIAL NUMBER (01) | CO |
| 21400253 | (05) | CO |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.