Individual provider · NPI-1
Mark Richard Gyenes, HS(IDC/DMT)
Military Health Care Provider, Independent Duty Corpsman · Memphis, TN
NPI number1104802875
StatusActive
Last updated in NPPESJul 13, 2026
Details
- NPI
- 1104802875
- Entity type
- Individual (NPI-1)
- Name
- Mr. Mark Richard Gyenes
- Credential
- HS(IDC/DMT)
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Dec 15, 2005
- Last updated
- Jul 13, 2026
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 1710I1002X | Military Health Care Provider, Independent Duty Corpsman | – | – | Yes |
| 146N00000X | Emergency Medical Technician, Basic | B1583538 | TN | |
| 1710I1003X | Military Health Care Provider, Independent Duty Medical Technicians | – | – | |
| 247000000X | Technician, Health Information | – | – | |
| 247200000X | Technician, Other | – | – | |
| 376K00000X | Nurse's Aide | A00065327 | MD | |
| 376K00000X | Nurse's Aide | 3900062 | TN |
Practice location
2 Auction AveMemphis, TN 38105-1502
Phone 901-544-3912 · Fax 901-544-3915
Mailing address
2 Auction AveMemphis, TN 38105-1502
Phone 901-544-3912 · Fax 901-544-3915
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