Mark B. Wall, MD PA

Primary specialty

Diagnostic Radiology PhysicianTaxonomy code 2085R0202X

Legal business name

MARK B. WALL, MD PA

Practice address

150 Reynoir St
Biloxi, MS 39530-4130

Phone

(228) 432-1571

NPI assigned

Mar 1, 2016

Organization subpart

No

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

Authorized official

Name

Dr. Mark Burnette Wall, MD

Title

President-Owner

Phone

(228) 875-0693

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1456790400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1456790400000",
    "number": "1407216617",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "202 WASHINGTON AVE",
            "city": "OCEAN SPRINGS",
            "state": "MS",
            "postal_code": "395644626",
            "telephone_number": "228-875-0693"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "150 REYNOIR ST",
            "city": "BILOXI",
            "state": "MS",
            "postal_code": "395304130",
            "telephone_number": "228-432-1571"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARK B. WALL, MD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-03-01",
        "last_updated": "2016-03-01",
        "status": "A",
        "authorized_official_last_name": "WALL",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "BURNETTE",
        "authorized_official_title_or_position": "PRESIDENT-OWNER",
        "authorized_official_telephone_number": "228-875-0693",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Radiology, Diagnostic Radiology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• William E Malone, OD
• Kerri Lyn Manjarrez, LCSW
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• Marisa D Stringer Consulting LLC (Nu Visage Aesthetics and Dermatology)
• Kelly Carter Markham, LCSW
• Clinton Wallace Martin Jr., PHD
• Frank Guice Martin, M.D.
• Helene Dionne Martin, LMSW
• Jackie H Martin, D.O.

• Diagnostic Radiology Physician in Biloxi, MS
• Providers in Biloxi, MS by specialty
• Diagnostic Radiology Physician in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 1, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.