DR. MARK SOUTHARD (NPI# 1003868811) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1003868811 |
| Entity Type | Individual |
| Full Name | DR. MARK SOUTHARD |
| Credential | MD |
| Practice Address |
900 W Clairmont Ave Eau Claire WI 54701 |
| Mailing Address |
2715 West Frank St Eau Claire WI 54703 |
| Practice Telephone | 7158394151 |
| Mailing Telephone | 7158345511 |
| Mailing Fax Number | 7158345870 |
| Enumeration Date | 2006-05-17 |
| Last Update Date | 2009-11-18 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 2085B0100X |
Radiology Specialization: Body Imaging |
45008 | WI | Allopathic & Osteopathic Physicians |
| Y | 2085R0202X |
Radiology Specialization: Diagnostic Radiology |
45008 | WI | Allopathic & Osteopathic Physicians |
| N | 2085U0001X |
Radiology Specialization: Diagnostic Ultrasound |
45008 | WI | Allopathic & Osteopathic Physicians |
| Street Address |
900 W CLAIRMONT AVE |
| City | EAU CLAIRE |
| State | WI |
| Zip Code | 54701 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649887563 | Molly Amanda Haferman | Pharmacist | 3184 London Road, Eau Claire, WI 54701 | 2020-09-24 |
| 1194375915 | Moments Hospice of Eau Claire LLC | Hospice Care, Community Based | 2263 East Ridge Center, Eau Claire, WI 54701 | 2019-09-13 |
| 1043778228 | Rita Marie Acosta | Emergency Medical Technician, Basic | 509 University Dr, Mcphee Atr, Eau Claire, WI 54701 | 2019-03-07 |
| 1619450954 | Michael Brown | Case Manager/Care Coordinator | 102 S Barstow St, Eau Claire, WI 54701 | 2018-09-12 |
| 1417436569 | Valerie Jayne Both | Social Worker | 1000 Starr Avenue, Eau Claire, WI 54701 | 2018-08-09 |
| 1023519055 | Rachel Delanois | Specialist/Technologist | Kinesiology --mcphee Physical Education Center 208, 509 University Drive, Eau Claire, WI 54701 | 2018-02-25 |
| 1427564863 | Matayla Springstroh | Specialist/Technologist | 509 University Drive, Eau Claire, WI 54701 | 2017-12-21 |
| 1265981062 | Molly Hart | Student in an Organized Health Care Education/Training Program | 509 University Dr., Eau Claire, WI 54701 | 2016-09-22 |
| 1982051918 | Renee Teigen-stary | Registered Nurse | 3440 Oakwood Hills Parkway, Eau Claire, WI 54701 | 2016-05-19 |
| 1699104059 | Susan Marie Keller | Speech-Language Pathologist | 3656 Mull Dr., Dove Healthcare - South, Eau Claire, WI 54701 | 2013-11-06 |
| Find all providers in zip 54701 | ||||
| Taxonomy Code | 2085R0202X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Radiology |
| Specialization | Diagnostic Radiology |
| A radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Radiology, 2007. http://www.theabr.org/. American Osteopathic Board of Radiology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Radiology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Radiology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871768457 | Wells Isaac Mangrum | Radiology | 3130 Anric Dr, Eau Claire, WI 54701-3054 | 2008-04-24 |
| 1619040672 | Alicia Christine Arnold | Radiology | 2715 W Frank St, Eau Claire, WI 54703-2593 | 2006-11-16 |
| 1255336897 | Vicki L. Hawn | Radiology | 2116 Craig Rd, Eau Claire, WI 54701-6149 | 2005-06-20 |
| 1710327077 | Cameron Leitch | Radiology | 1400 Bellinger St, Eau Claire, WI 54703-5222 | 2013-07-01 |
| 1114157369 | Erik B. Sviggum | Radiology | 1400 Bellinger St, Eau Claire, WI 54703-5222 | 2009-07-22 |
| 1568696573 | Megan Meyers | Radiology | 1400 Bellinger St, Eau Claire, WI 54703-5222 | 2009-05-05 |
| 1497997050 | Ryan Sykes Jean-baptiste | Radiology | 1400 Bellinger St, Eau Claire, WI 54703-5222 | 2009-03-29 |
| 1093905861 | Jeremy Frank Mcbride | Radiology | 1400 Bellinger St, Eau Claire, WI 54703 | 2007-07-27 |
| 1821295635 | James Jeremy Kinsella | Radiology | 2116 Craig Rd, Eau Claire, WI 54701-6149 | 2007-06-27 |
| 1972642916 | Peter Edward Humphrey Jr. | Radiology | 2116 Craig Rd, Eau Claire, WI 54701 | 2007-02-06 |
| Find all providers in EAU CLAIRE | ||||
| City | EAU CLAIRE |
| Zip Code | 54701 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.