Mark S Short, PA-C
NPI #1194748863 in Fort Leonard Wood, Missouri
Provider Information
- NPI Number
- 1194748863
- Entity Type
- Individual
- Name
- Mark S Short, PA-C
- Gender
- Not Specified
- Sole Proprietor
- No
- Primary Specialty
- Physician Assistant
- Credential
- PA-C
- Enumeration Date
- Jul 25, 2006
- Last Updated
- May 6, 2021
Practice Location
- Address
- 126 MISSOURI AVE
- Address 2
- MCXP-CCS-CR
- State
- Missouri
- ZIP Code
- 65473-8952
- Phone
- (573) 596-0417
Specialties & Taxonomy Codes
| Specialty |
|---|
| Physician Assistant |
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