Provider Demographics
NPI:1508077892
Name:AKERS, MARK JASON (MD)
Entity type:Individual
Prefix:
First Name:MARK
Middle Name:JASON
Last Name:AKERS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 910
Mailing Address - Street 2:
Mailing Address - City:HUNTINGTON
Mailing Address - State:WV
Mailing Address - Zip Code:25712-0910
Mailing Address - Country:US
Mailing Address - Phone:304-522-1550
Mailing Address - Fax:304-522-1073
Practice Address - Street 1:3448 US ROUTE 60
Practice Address - Street 2:
Practice Address - City:HUNTINGTON
Practice Address - State:WV
Practice Address - Zip Code:25705-2906
Practice Address - Country:US
Practice Address - Phone:304-522-1550
Practice Address - Fax:304-522-1073
Is Sole Proprietor?:No
Enumeration Date:2007-05-25
Last Update Date:2024-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY425122085R0202X
OH35.0898752085R0202X
WV233802085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV550493376 00OtherWV WORKER'S COMPENSATION
WVP00766023OtherRR MEDICARE (WV)
WV002099842OtherMOUNTAIN STATE BCBS
9353150OtherAETNA
KYP00729748OtherRR MEDICARE (KY)
KY7100046710Medicaid
OH000000269729OtherUNISON
OH2848593Medicaid
WV3810014632Medicaid
KY50024310OtherPASSPORT
9353150OtherAETNA
KY50024310OtherPASSPORT
KY7100046710Medicaid