MR. MARK ROBERT BACON PA-C NPI 1972530053

NPI Information

NPI: 1972530053
Provider Name: MR. MARK ROBERT BACON, PA-C
Classification: Physician Assistant - 363AM0700X
Entity Type: Individual

Specialization: Medical

Address:
72ND MEDICAL GROUP
5700 ARNOLD ST
TINKER AFB, OK
ZIP 73145
Phone: (405) 736-4943
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MR. Mark Robert Bacon, PA-C is a medical physician assistant in Tinker Afb, OK. MR. Mark Robert Bacon, PA-C NPI is 1972530053. 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:

72ND MEDICAL GROUP
5700 ARNOLD ST
TINKER AFB, OK
ZIP 73145
Phone: (405) 736-4943

The enumeration date for this NPI number is 6/26/2006 and was last updated on 7/8/2007.

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	363AM0700X	Physician Assistant	Medical	602	ALASKA	No
2	363AM0700X	Physician Assistant	Medical	1389	OKLAHOMA	Yes

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: 5/5/2024

NPI Synchronization or Removal

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