DR. MARK BURNETTE WALL (NPI# 1053447268) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1053447268 |
| Entity Type | Individual |
| Full Name | DR. MARK BURNETTE WALL |
| Credential | M.D. |
| Practice Address |
150 Reynoir St Biloxi MS 39530-4130 |
| Mailing Address |
P O Box 604 135 Main St Biloxi MS 39530 |
| Practice Telephone | 2284361111 |
| Mailing Telephone | 2284321111 |
| Enumeration Date | 2007-02-24 |
| Last Update Date | 2018-04-27 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2085R0202X |
Radiology Specialization: Diagnostic Radiology |
20161 | MS | Allopathic & Osteopathic Physicians |
| N | 2085R0202X |
Radiology Specialization: Diagnostic Radiology |
00025773 | AL | Allopathic & Osteopathic Physicians |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265617484 | Mark Wall | Counselor | 5030 Maple Springs Blvd, Dallas, TX 75235-8321 | 2008-01-07 |
| Street Address |
150 REYNOIR ST |
| City | BILOXI |
| State | MS |
| Zip Code | 39530-4130 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174516108 | Professional Pathology Associates | Specialist | 150 Reynoir St, Biloxi, MS 39530-4130 | 2005-08-24 |
| 1831719632 | Biloxi Hma LLC | Clinical Medical Laboratory | 150 Reynoir St, Biloxi, MS 39530-4130 | 2020-04-21 |
| 1124597224 | Shelbey Elise Simpson | Physician Assistant | 150 Reynoir St, Biloxi, MS 39530-4130 | 2018-11-19 |
| 1093298754 | Brandy Lynn Westman | Nurse Practitioner | 150 Reynoir St, Biloxi, MS 39530-4130 | 2018-09-10 |
| 1407364482 | Gci Radiology Pllc | Specialist | 150 Reynoir St, Biloxi, MS 39530 | 2018-01-12 |
| 1538678438 | Allen Carter Nelson | Nurse Practitioner | 150 Reynoir St, Biloxi, MS 39530 | 2017-09-22 |
| 1245771856 | Harrison Physician Services, LLP | Physician Assistant | 150 Reynoir St, Biloxi, MS 39530-4130 | 2017-03-15 |
| 1619419900 | Kenyada Marshall | Nurse Practitioner | 150 Reynoir St, Biloxi, MS 39530-4130 | 2016-11-17 |
| 1134574429 | Adam L Whitaker | Emergency Medicine | 150 Reynoir St, Biloxi, MS 39530-4130 | 2016-04-25 |
| 1407216617 | Mark B. Wall, Md Pa | Radiology | 150 Reynoir St, Biloxi, MS 39530-4130 | 2016-03-01 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588158125 | Gulf Coast Anesthesia Associates | Anesthesiology | 147 Reynoir St Ste 305, Biloxi, MS 39530 | 2018-06-18 |
| 1326486804 | Pavilion Personal Care LLC | In Home Supportive Care | 1450b Beach Blvd, Biloxi, MS 39530 | 2013-06-06 |
| 1366707713 | Makeva K Reed | Nurse Practitioner | 321 Division St, Biloxi, MS 39530 | 2012-07-11 |
| 1174833602 | Keith Edward Earley Jr. | Ophthalmology | 301 Fisher Ave, Keesler Afb, MS 39530 | 2010-10-18 |
| 1730406729 | Alexander H. Nguyen | Surgery | 4503 M St, Biloxi, MS 39530 | 2010-04-29 |
| 1881891265 | Tina Fleming Mcgrew | Nurse Practitioner | 321-b Divison Street, Biloxi, MS 39530 | 2007-06-29 |
| 1285857623 | South Mississippi Nephrology, Pllc | Internal Medicine | 784 Vieux Marche, Biloxi, MS 39530 | 2007-04-11 |
| 1164573515 | Keith G Goodfellow | Obstetrics & Gynecology | 147 Reynoir St Ste 105, Biloxi, MS 39530 | 2007-01-14 |
| 1871640292 | Doreen Brock | Nurse Practitioner | 1046 Division Street, Biloxi, MS 39530 | 2007-01-05 |
| 1922069715 | Garvin Wallace Cunningham | Dentist | 683 Division St, Biloxi, MS 39530 | 2006-03-31 |
| Find all providers in zip 39530 | ||||
| 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 |
|---|---|---|---|---|
| 1982603262 | Neuro Diagnostics, Inc. | Radiology | 240 Eisenhower Dr, Ste C-5, Biloxi, MS 39531-3654 | 2005-07-19 |
| 1407852429 | Shaun W Mckee | Radiology | 1720c Medical Park Dr, Biloxi, MS 39532-2131 | 2005-06-23 |
| 1407216617 | Mark B. Wall, Md Pa | Radiology | 150 Reynoir St, Biloxi, MS 39530-4130 | 2016-03-01 |
| 1932585221 | Biloxi Radiology Pa | Radiology | 150 Reynoir St, Biloxi, MS 39530-4130 | 2015-08-10 |
| 1992078950 | Cedar Lake Open Mri LLC | Radiology | 1720c Medical Park Dr, Biloxi, MS 39532-2131 | 2012-02-21 |
| 1831328632 | Mckean Radiology, Pllc | Radiology | 150 Reynoir St, Biloxi, MS 39530-4130 | 2009-07-14 |
| 1922273408 | Harrison Hma | Radiology | 180 Debuys Rd, Biloxi, MS 39531-4402 | 2008-04-25 |
| 1194990671 | Biloxi Hma | Radiology | 150 Reynoir St, Biloxi, MS 39530-4130 | 2008-04-25 |
| 1447438387 | Medicus Radiology Pllc | Radiology | 150 Reynoir St, Biloxi, MS 39530-4130 | 2008-02-02 |
| 1497874309 | South Shore Radiology, LLC | Radiology | 150 Reynoir St, Biloxi, MS 39530-4130 | 2007-03-29 |
| Find all providers in BILOXI | ||||
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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.