Mark T. Kowal MD PC

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

License

7319 Issued in AK

Legal business name

MARK T. KOWAL MD PC

Practice address

1919 Lathrop St
Suite 202
Fairbanks, AK 99701-5937

Phone

(907) 451-5507

Fax

(907) 451-5590

NPI assigned

Oct 21, 2011

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Mark Timothy Kowal, MDNPI 1285855239

Title

General Surgeon

Phone

(907) 451-5507

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in AK

Enrollment records 1

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Mark Timothy Kowal, M.D.

  • Surgery Physician
  • Fairbanks, AK
  • NPI 1285855239
  Medicare reassignment NPD Authorized official
• Amber J Ross, PA-C

  • Physician Assistant
  • Fairbanks, AK
  • NPI 1629559752
  Medicare reassignment

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1319155200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1482796800000",
    "number": "1205112240",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1919 LATHROP ST",
            "address_2": "SUITE 202",
            "city": "FAIRBANKS",
            "state": "AK",
            "postal_code": "997015937",
            "telephone_number": "907-451-5507",
            "fax_number": "907-451-5590"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1919 LATHROP ST",
            "address_2": "SUITE 202",
            "city": "FAIRBANKS",
            "state": "AK",
            "postal_code": "997015937",
            "telephone_number": "907-451-5507",
            "fax_number": "907-451-5590"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARK T. KOWAL MD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-10-21",
        "last_updated": "2016-12-27",
        "status": "A",
        "authorized_official_last_name": "KOWAL",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "TIMOTHY",
        "authorized_official_title_or_position": "GENERAL SURGEON",
        "authorized_official_telephone_number": "907-451-5507",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "AK",
            "license": "7319",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Guy Chris Mannino, D.C.
• Jovia Manzie
• Amy C Manzinas
• Miozoty Marante Cruz
• Nogah Marchildon
• Dennette Marks
• Malea Marks
• Kathy Marley, CARE COORDINATOR
• Joel Marquess
• Lisa Marquez-Cecil

• Clinic/Center in Fairbanks, AK
• Providers in Fairbanks, AK by specialty
• Clinic/Center in Alaska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 27, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.