MR. Mark Robert Bacon, PA-C
NPI #1972530053 in Tinker Afb, Oklahoma
Provider Information
- NPI Number
- 1972530053
- Entity Type
- Individual
- Name
- MR. Mark Robert Bacon, PA-C
- Gender
- Not Specified
- Sole Proprietor
- No
- Primary Specialty
- Physician Assistant - Medical
- Credential
- PA-C
- Enumeration Date
- Jun 26, 2006
- Last Updated
- Jul 8, 2007
Practice Location
- Address
- 72ND MEDICAL GROUP
- Address 2
- 5700 ARNOLD ST
- City
- Tinker Afb
- State
- Oklahoma
- ZIP Code
- 73145
- Phone
- (405) 736-4943
Specialties & Taxonomy Codes
| Specialty |
|---|
| Physician Assistant - Medical — Medical |
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