MR. MARK ANDREW WILK NPI 1790905131

NPI Information

NPI: 1790905131
Provider Name: MR. MARK ANDREW WILK
Classification: Contractor - 171WH0202X
Entity Type: Individual

Specialization: Home Modifications

Address:
2011 W. DAVIS ROAD
PHOENIX, AZ
ZIP 85023
Phone: (602) 942-6421
Get Directions

MR. Mark Andrew Wilk is a home modifications contractor in Phoenix, AZ. MR. Mark Andrew Wilk NPI is 1790905131. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

2011 W. DAVIS ROAD
PHOENIX, AZ
ZIP 85023-802
Phone: (602) 942-6421
Fax: (602) 564-2840

The enumeration date for this NPI number is 4/26/2007 and was last updated on 7/9/2007.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	171WH0202X	Contractor	Home Modifications	ROC 165112	ARIZONA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	631029	MEDICAID	ARIZONA
2	436908	MEDICAID	ARIZONA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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