Provider Demographics
NPI:1104935089
Name:FLYNN, MARK HERBERT (DC)
Entity type:Individual
Prefix:DR
First Name:MARK
Middle Name:HERBERT
Last Name:FLYNN
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:229 DELAWARE AVE
Mailing Address - Street 2:
Mailing Address - City:OAKMONT
Mailing Address - State:PA
Mailing Address - Zip Code:15139-2016
Mailing Address - Country:US
Mailing Address - Phone:412-828-8700
Mailing Address - Fax:412-828-9755
Practice Address - Street 1:229 DELAWARE AVE
Practice Address - Street 2:
Practice Address - City:OAKMONT
Practice Address - State:PA
Practice Address - Zip Code:15139-2016
Practice Address - Country:US
Practice Address - Phone:412-828-8700
Practice Address - Fax:412-828-9755
Is Sole Proprietor?:No
Enumeration Date:2006-08-30
Last Update Date:2008-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC003619L111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA108026OtherHIGHMARK
PA108026OtherMEDICARE