Dr MARK WILLIAMS WALLER MD is a male medical professional, specializing in Anesthesiology. He graduated in 1991 from University Of Oklahoma College Of Medicine.
ST. JOHN ANESTHESIA SERVICES, INC.
12451 E 100TH ST N
ST JOHN OWASSO
OWASSO
OK
740554600
Tel: 9187443664
| Npi | 1265494314 |
| Pac Id | 3971527086 |
| Professional Enrollment Id | I20060117000277 |
| Last Name | WALLER |
| First Name | MARK |
| Middle Name | WILLIAMS |
| Suffix | |
| Gender | M |
| Credential | MD |
| Medical School Name | UNIVERSITY OF OKLAHOMA COLLEGE OF MEDICINE |
| Graduation Year | 1991 |
| Primary Specialty | ANESTHESIOLOGY |
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| Organization Legal Name | ST. JOHN ANESTHESIA SERVICES, INC. |
| Group Practice Pac Id | 4789607938 |
| Number Of Group Practice Members | 95 |
| Line 1 Street Address | 12451 E 100TH ST N |
| Line 2 Street Address | ST JOHN OWASSO |
| Marker Of Address Line 2 Suppression | |
| City | OWASSO |
| State | OK |
| Zip Code | 740554600 |
| Phone Number | 9187443664 |
| Hospital Affiliation Ccn 1 | 370114 |
| Hospital Affiliation Lbn 1 | ST JOHN MEDICAL CENTER, INC |
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| Professional Accepts Medicare Assignment | Y |
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