Individual provider · Type 1 NPI
Mark T. Wilt, DPM
Foot & Ankle Surgery Podiatrist · Princeton, WV
NPI number
1053580696
Active
Practice location
401 Rogers St
Princeton, WV 24740-3636
Fax (330) 629-9181
Mailing address
PO Box 365
Prosperity, WV 25909-0365
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Podiatrist | 213E00000X | 10402 (WV) |
| Foot & Ankle Surgery Podiatrist | 213ES0103X | 10402 (WV) |
| Podiatrist | 213E00000X | 36-003486 (OH) |
| Foot & Ankle Surgery Podiatrist Primary | 213ES0103X | 0103301014 (VA) |
| Podiatrist | 213E00000X | 0103301014 (VA) |
Foot & Ankle Surgery Podiatrist: Definition to come...
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Other foot & ankle surgery podiatrist providers in Princeton
About NPI 1053580696
Mark T. Wilt, DPM's National Provider Identifier is 1053580696, issued on Feb 28, 2008. The primary taxonomy on file is Foot & Ankle Surgery Podiatrist (213ES0103X), and the practice location is in Princeton, WV. The record was last updated on Oct 1, 2009.