Mark Witaczack, DO is a
Radiology - Diagnostic Radiology physician based in Chanute, Kansas. Mark Witaczack is licensed to practice in Kansas (license number 05-20132) and his current practice location is 629 S Plummer, Chanute, Kansas. He can be reached at his office (for appointments etc.) via phone at
(316) 321-5900.
NPI number for Mark Witaczack is 1104962182 and his current mailing address is Po Box 662, Chanute, Kansas. He
does not participate in medicare program and thus does not accept medicare assignments. His NPI Number is 1104962182.
Physician's Profile
| Full Name | Mark Witaczack |
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| Gender | Male |
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| Speciality | Radiology - Diagnostic Radiology |
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| Location | 629 S Plummer, Chanute, Kansas |
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| Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
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NPI Data:
- NPI Number: 1104962182
- Provider Enumeration Date: 01/29/2007
- Last Update Date: 07/08/2007
Medical Identifiers
Medical identifiers for Mark Witaczack such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1104962182 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 2085R0202X | Radiology - Diagnostic Radiology | 05-20132 (Kansas) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Mark Witaczack is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Mark Witaczack, DO
Po Box 662,
Chanute, KS 66720
Ph: () - | Mark Witaczack, DO
629 S Plummer,
Chanute, KS 66720
Ph: (316) 321-5900 |
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