Mark Rollo Halverson in Fort Worth - Pediatric Radiology
Mark Rollo Halverson - NPI 1619175890
Mark Rollo Halverson is a Pediatric Radiology in Fort Worth, Texas. Mark Rollo Halverson practices all healthcare services and medical treatments related to Pediatric Radiology. The NPI Number for Mark Rollo Halverson is 1619175890. The last update date is 2014-09-19.
Mark Rollo Halverson's current location address is 816 W Cannon St, Fort Worth, Texas. You can contact this provider via phone number 8173210387. The mailing address for Mark Rollo Halverson is 816 W Cannon St, Fort Worth, Texas. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Mark Rollo Halverson |
|---|---|
| Address | 816 W Cannon St, Fort Worth, Texas |
| Phone Number | 8173210387 |
| Fax Number | |
| Sole Proprietor | N |
| Credentials | MD |
NPI Number Detail
| NPI Number | 1619175890 |
|---|---|
| Provider Enumeration Date | 2007-07-10 |
| Last Updated Date | 2014-09-19 |
Provider Mailing Address Detail
| Address | 816 W Cannon St |
|---|---|
| City | Fort Worth |
| State | Texas (TX) |
| Post Code | 761043146 |
| Phone Number | 8173210387 |
| Fax Number |
Provider's Primary Taxonomy Detail
| Speciality | Pediatric Radiology |
|---|---|
| Taxonomy | 2085P0229X |
| Licence No | MD445798 |
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Definition: A radiologist who is proficient in all forms of diagnostic imaging as it pertains to the treatment of diseases in the newborn, infant, child and adolescent. This specialist has knowledge of both imaging and interventional procedures related to the ca |
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Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 285250104 | TX | -- | |
| 121715004 | TX | -- | |
| 121715008 | TX | -- |
Post Comment/ Review Below
What is the unique 10-digit identifier code assigned to Mark Rollo Halverson by the Centers for Medicare & Medicaid Services?
The Mark Rollo Halverson has been issued the NPI (National Provider Identifier) 1619175890 by the CMS (Centers for Medicare & Medicaid Services), which serves as a unique identification number for healthcare providers.
Could you share the physical location details of Mark Rollo Halverson?
The Mark Rollo Halverson is situated at 816 W Cannon St, in the city of Fort Worth, state of TX, with the zip code 761043146.
What is Mark Rollo Halverson's specialized field of practice, and what is the corresponding taxonomy classification code?
The Mark Rollo Halverson's area of specialization is Pediatric Radiology, and the corresponding taxonomy code that categorizes this field of practice is 2085P0229X.
On what date did the Mark Rollo Halverson receive its 1619175890 assignment from the Centers for Medicare & Medicaid Services?
The Mark Rollo Halverson was assigned its 1619175890 by the Centers for Medicare & Medicaid Services on 2007-07-10.
As of what date were the details related to Mark Rollo Halverson most recently updated or revised?
The information pertaining to Mark Rollo Halverson, including its address, specialty, and other relevant details, was last updated or revised on 2014-09-19.