Active NPI
Mark Douglas Fossey, MD
- Psychiatry Physician
- Muskogee, OK
National Provider Identifier
1083684476
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- 11793
- Practice address
- 1011 Honor Heights Dr
Jack C. Montgomery Vamc
Muskogee, OK 74401-1318 - Phone
- (918) 577-3031
- NPI assigned
- Jan 26, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | 11793 | OK | Primary |
Addresses
Primary practice location
1011 Honor Heights Dr
Jack C. Montgomery Vamc
Muskogee, OK 74401-1318
Mailing address
PO Box 21228
Department 31
Tulsa, OK 74121-1228
Phone (918) 491-3762
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 100118230A | Medicaid | OK |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 11793 | OK | MD | Psychiatry Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1138233600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1788652800000",
"number": "1083684476",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 21228",
"address_2": "DEPARTMENT 31",
"city": "TULSA",
"state": "OK",
"postal_code": "741211228",
"telephone_number": "918-491-3762",
"fax_number": "918-491-5740"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1011 HONOR HEIGHTS DR",
"address_2": "JACK C. MONTGOMERY VAMC",
"city": "MUSKOGEE",
"state": "OK",
"postal_code": "744011318",
"telephone_number": "918-577-3031"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FOSSEY",
"first_name": "MARK",
"middle_name": "DOUGLAS",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-01-26",
"last_updated": "2026-09-06",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "OK",
"license": "11793",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "100118230A",
"state": "OK"
}
],
"endpoints": [],
"other_names": []
}Other providers in Muskogee, OK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 6, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.