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Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.

MARK WAYNNE PAULETICH, RRT

Active Sole Proprietor

MARK WAYNNE PAULETICH, RRT is a 2279C0205X healthcare provider located in FORT DEFIANCE, Arizona. NPI 1659957058 is currently active in the NPPES registry. Verify at CMS.

2279C0205X · FORT DEFIANCE, AZ

Registration Details

NPI Number
1659957058
Provider Type
Individual
Gender
Male
NPI Issued
Mar 24, 2021 (5.3508689932857 yrs)
Last Updated
Mar 24, 2021
License
3645 (MN)
Sole Proprietor
Yes

Practice Information

Address
N7, N12 & FORT DEFIANCE
FORT DEFIANCE, AZ, 86504
Browse AZ providers · Browse ZIP 86504
Phone
9287298000
Primary Specialty
2279C0205X
2279C0205X

Other 2279C0205X Providers in FORT DEFIANCE, AZ

Name Credential NPI
MRS. TRISHA ANN WILLIAMS RRT 1902234461
KEVIN BOUDINOT 1003549304
JERMAL JACKSON RRT 1760115992
ZIA HAIDER 1821701244
JAMES CLIPPINGER II RRT 1538848486
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.