MARK D FETTER MD PC (NPI# 1124107206) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1124107206 |
| Entity Type | Organization |
| Organization Name | MARK D FETTER MD PC |
| Practice Address |
1615 Petroglyph Point Dr Prescott AZ 86301-6539 |
| Practice Telephone | 4809851093 |
| Mailing Telephone | 4809851093 |
| Enumeration Date | 2006-11-02 |
| Last Update Date | 2007-10-10 |
| Authorized Official Name | DR. MARK D FETTER (PRESIDENT) |
| Authorized Official Telephone | 4809851093 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207XS0106X |
Orthopaedic Surgery Specialization: Hand Surgery |
Allopathic & Osteopathic Physicians |
| Street Address |
1615 PETROGLYPH POINT DR |
| City | PRESCOTT |
| State | AZ |
| Zip Code | 86301-6539 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568427490 | Mark Fetter | Specialist | 1615 Petroglyph Point Dr, Prescott, AZ 86301-6539 | 2006-04-20 |
| 1932733565 | Phoenix Anesthesia Specialists, LLC | Nurse Anesthetist, Certified Registered | 1615 Petroglyph Point Dr, Prescott, AZ 86301-6539 | 2020-02-21 |
| 1740415157 | Matthew J Sauget | Nurse Anesthetist, Certified Registered | 1615 Petroglyph Point Dr, Prescott, AZ 86301-6539 | 2009-05-29 |
| 1447458591 | Advanced Plastic Surgery Center, L.L.C. | Clinic/Center | 1615 Petroglyph Point Dr, Prescott, AZ 86301-6539 | 2007-07-10 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871102350 | Dove Marie Gundermann | Specialist/Technologist | 300 W. Gurley St, Prescott, AZ 86301 | 2020-07-30 |
| 1639712110 | Arizona Orthopedic Physical Therapy, Pllc | Clinic/Center | 1781 E State Highway 69, Suite 28, Prescott, AZ 86301 | 2019-10-28 |
| 1538714092 | Prescott Complete Care | Family Medicine | 1947 Commerce Center Circle, Suite A, Prescott, AZ 86301 | 2019-08-01 |
| 1336612571 | Sarah Elizabeth Elliott | Registered Nurse | 500 Az 89, Prescott, AZ 86301 | 2019-01-10 |
| 1912484270 | Asya Ruth Perkins | Counselor | 225 Grove Avenue, Prescott, AZ 86301 | 2018-07-19 |
| 1396241394 | Jerome Alexander Longoria | Chiropractor | 142 N. Rush St, Prescott, AZ 86301 | 2018-03-30 |
| 1619487675 | Yavapai Healthcare Group LLC | Nurse Practitioner | 999 Division Street, Prescott, AZ 86301 | 2017-10-04 |
| 1053835843 | United States Veterans Initiative | Counselor | 917 E Gurley St, Prescott, AZ 86301 | 2017-08-02 |
| 1164896999 | Spitler - Lilley, LLC | Hearing Instrument Specialist | 1781 E. State Rte 69, Suite 65, Prescott, AZ 86301 | 2015-11-17 |
| 1275925265 | Oral and Facial Surgery Center of Prescott | Dentist | 5415 Distiction Way, Prescott, AZ 86301 | 2015-02-27 |
| Find all providers in zip 86301 | ||||
| Taxonomy Code | 207XS0106X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Orthopaedic Surgery |
| Specialization | Hand Surgery |
| An orthopaedic surgeon trained in the investigation, preservation and restoration by medical, surgical and rehabilitative means of all structures of the upper extremity directly affecting the form and function of the hand and wrist. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Orthopaedic Surgery, 2007. http://www.abos.org/. American Osteopathic Board of Orthopaedic Surgery, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Orthopaedic Surgery. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Orthopaedic Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609420702 | Orthopedic Specialists of North America Pllc | Orthopaedic Surgery | 10250 N 92nd St Ste 308, Scottsdale, AZ 85258-4520 | 2019-07-26 |
| 1437569787 | Orthopedic Specialists of North America, Pllc | Orthopaedic Surgery | 20333 N 19th Ave, Suite 230, Phoenix, AZ 85027-3600 | 2014-05-07 |
| 1255741500 | Osna Pllc | Orthopaedic Surgery | 21231 E. Ocotillo Rd., Suite 134, Queen Creek, AZ 85142-5995 | 2014-05-07 |
| 1982942579 | Hand & Upper Extremity Specialists, P.C. | Orthopaedic Surgery | 10250 N 92nd St Ste 110, Scottsdale, AZ 85258-4518 | 2013-01-16 |
| 1225350044 | Orthopedic Specialists of North America, Pllc | Orthopaedic Surgery | 3530 W Val Vista Dr, Ste B105, Gilbert, AZ 85297-7318 | 2010-02-20 |
| 1770812828 | Orthopedic Specialists of North America, Pllc | Orthopaedic Surgery | 3033 N 44th St Ste 360, Phoenix, AZ 85018-7276 | 2009-12-21 |
| 1437238078 | David Allen Thull | Orthopaedic Surgery | 9220 E Mountain View Rd, Ste 102, Scottsdale, AZ 85258-5134 | 2006-11-03 |
| 1164507190 | Canyon Orthopaedic Surgeons, A Division of Osna, Pllc | Orthopaedic Surgery | 6760 W Thunderbird Rd, Ste E110, Peoria, AZ 85381-5048 | 2006-10-26 |
| 1053365528 | Leonard Bodell | Orthopaedic Surgery | 370 E Virginia Ave Ste 100, Phoenix, AZ 85004-1254 | 2006-05-20 |
| 1679563167 | Douglas A Bobb | Orthopaedic Surgery | 15830 N 35th Ave, Phoenix, AZ 85053-7640 | 2005-10-25 |
| Find all providers with the same taxonomy | ||||
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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.