Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Laquisha S Mark, MD

Individual provider Student in an Organized Health Care Education/Training Program · NPI 1679739163

Laquisha S Mark, MD is a Family Practice in Dayton, Ohio. Qualified in 2006, 20 years ago. Practices with Southern California Permanente Medical Group, an 11,242-clinician group and accepts Medicare assignment. Licensed in Ohio.

Years since qualifying
20
Licensed in
OH
In the registry since
2008
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

2345 Philadelphia Dr
Dayton, OH 45406-1816
Phone: (937) 276-4141
Fax: (937) 277-7249
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Student in an Organized Health Care Education/Training Program (primary) Taxonomy 390200000X · Licence 57-014699 (OH)

Record details

NPI number1679739163
Entity typeIndividual (Type 1)
GenderFemale
Credentials MD
Sole proprietorNo
NPI enumeratedAugust 4, 2008
Last updated in NPPESDecember 2, 2021
Certification dateDecember 2, 2021
Mailing address529 Crawley Run, Apt. #208, Centerville, OH 45458-6396

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyFAMILY PRACTICE
Medical schoolOTHER
Graduated 2006 (20 years in practice)
Group practice Southern California Permanente Medical Group — 11242 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

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