| Mark S Short, PA-C | |
|
126 Missouri Ave, Mcxp-ccs-cr, Fort Leonard Wood, MO 65473-8952 | |
| (573) 596-0417 | |
| (573) 596-0524 |
| Full Name | Mark S Short |
|---|---|
| Gender | Male |
| Speciality | Physician Assistant |
| Location | 126 Missouri Ave, Fort Leonard Wood, Missouri |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1194748863 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 363A00000X | Physician Assistant | 2011012296 (Missouri) | Primary |
| Mailing Address | Practice Location Address |
|---|---|
| Mark S Short, PA-C 126 Missouri Ave, Mcxp-ccs-cr, Fort Leonard Wood, MO 65473-8952 Ph: (573) 596-0417 | Mark S Short, PA-C 126 Missouri Ave, Mcxp-ccs-cr, Fort Leonard Wood, MO 65473-8952 Ph: (573) 596-0417 |
Mr. Jon-marc Thibodeau, PA-C Physician Assistant Medicare: Not Enrolled in Medicare Practice Location: 4430 Missouri Ave, Fort Leonard Wood, MO 65473 Phone: 573-596-0035 | |
Rickey Rodger Martin, PA Physician Assistant Medicare: Not Enrolled in Medicare Practice Location: 126 Missouri Ave, Fort Leonard Wood, MO 65473 Phone: 573-596-0417 Fax: 573-596-0524 | |
Charles Gang, P.A. Physician Assistant Medicare: Not Enrolled in Medicare Practice Location: 4430 Missouri Ave, Fort Leonard Wood, MO 65473 Phone: 573-596-0417 | |
Mr. Rexford Allan Plank Jr., PA-C Physician Assistant Medicare: Medicare Enrolled Practice Location: 126 Missouri Ave, Mcxp-ccs-cr, Fort Leonard Wood, MO 65473 Phone: 573-596-0417 Fax: 573-596-0524 | |
Toben Lybarger, PHYSICIAN ASSISTANT Physician Assistant Medicare: Not Enrolled in Medicare Practice Location: 126 Missouri Ave, Fort Leonard Wood, MO 65473 Phone: 573-596-0456 | |
Michael Steven Godat, PA-C Physician Assistant Medicare: Not Enrolled in Medicare Practice Location: 126 Missouri Ave, Mcxp-ccs-cr, Fort Leonard Wood, MO 65473 Phone: 573-596-0417 Fax: 573-596-0524 |