Provider Demographics
NPI:1174539266
Name:REMINGTON, MARK C (MD)
Entity type:Individual
Prefix:
First Name:MARK
Middle Name:C
Last Name:REMINGTON
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:175 TIMBERWOLF PKWY
Mailing Address - Street 2:
Mailing Address - City:KALISPELL
Mailing Address - State:MT
Mailing Address - Zip Code:59901-1218
Mailing Address - Country:US
Mailing Address - Phone:406-257-2020
Mailing Address - Fax:406-257-5554
Practice Address - Street 1:175 TIMBERWOLF PKWY
Practice Address - Street 2:
Practice Address - City:KALISPELL
Practice Address - State:MT
Practice Address - Zip Code:59901-1218
Practice Address - Country:US
Practice Address - Phone:406-257-2020
Practice Address - Fax:406-257-5554
Is Sole Proprietor?:No
Enumeration Date:2006-07-31
Last Update Date:2015-02-27
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Provider Licenses
StateLicense IDTaxonomies
MT8438207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MT0108030Medicaid
MT0108030Medicaid
MT0108030Medicaid