Mark L Westphal

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

Legal business name

MARK L WESTPHAL

Practice address

665 E Lake Rd
Carbondale, IL 62901-5347

Phone

(618) 549-0841

Fax

(618) 529-2442

NPI assigned

Mar 12, 2024

Organization subpart

No

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

Authorized official

Name

Mark L Westphal, MDNPI 1043388242

Title

President

Phone

(618) 549-0841

Specialties & licenses 1

Addresses

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Mark Louis Westphal, MD

  • Dermatology Physician
  • Carbondale, IL
  • NPI 1043388242
  NPD Authorized official
• Kelly K Hand, PA

  • Physician Assistant
  • Carbondale, IL
  • NPI 1851502421
  NPD (past)

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

{
    "created_epoch": "1710201600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1710201600000",
    "number": "1477311694",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 399",
            "city": "CARBONDALE",
            "state": "IL",
            "postal_code": "629030399",
            "telephone_number": "618-549-0841",
            "fax_number": "618-529-2442"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "665 E LAKE RD",
            "city": "CARBONDALE",
            "state": "IL",
            "postal_code": "629015347",
            "telephone_number": "618-549-0841",
            "fax_number": "618-529-2442"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARK L WESTPHAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-03-12",
        "last_updated": "2024-03-12",
        "certification_date": "2024-03-12",
        "status": "A",
        "authorized_official_last_name": "WESTPHAL",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "618-549-0841",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dermatology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tara Manzano, OTR/L
• Allen Wayne Mardis, ATC
• Abbey Margolis, MSW, LSW
• Marion Eye Centers LTD
• Marion Eye Centers LTD.
• Vivian L Marks, NP
• Natasha Marshall
• Adrian P Martin, M.D.
• Emily L Martin, NP
• Gerald S Martin, NP

• Dermatology Physician in Carbondale, IL
• Providers in Carbondale, IL by specialty
• Dermatology Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 12, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.