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Contact Information

MARK A CRISWELL, M.D., F.A.C.S.
307 BOATNER RD STE 114
EGLIN AFB, FL32542
 Phone: 850-883-8264
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Otolaryngology

207Y00000X 04 Physician/Otolaryngology
 

Plastic Surgery within the Head & Neck

207YX0007X 04 Physician/Otolaryngology
 

Sleep Medicine

207YS0012X 04 Physician/Otolaryngology
Indicates primary specialty

NPI Profile & details for MARK A CRISWELL · (Male)

NPI Number 1619947033
Status Active
Credentials M.D., F.A.C.S.
Entity Individual
Enumeration date 01/26/2006
Last updated 07/11/2018 - About 8 years ago
Sole proprietor 1 No
Identifiers
  • CO License # 00056111
  • CO License # 0056111
  • IN License # 01046367A
  • CO Medicaid 21400253
  • CO Other 027034 KAISER COMMERCIAL NUMBER
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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