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

Individual provider Specialist · NPI 1568427490

Mark Fetter, MD is a Plastic and Reconstructive Surgery in Prescott, Arizona. Graduated from Wright State University Boonshoft School of Medicine in 1988, 38 years ago. Accepts Medicare assignment. Licensed in Arizona.

Years since qualifying
38
Trained at
Wright State University Boonshoft School of Medicine
Licensed in
AZ
In the registry since
2006
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

1615 Petroglyph Point Dr
Prescott, AZ 86301-6539
Phone: (928) 777-0200
Fax: (928) 443-1117
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Specialist (primary) Taxonomy 174400000X · Licence 24439 (AZ)

Record details

NPI number1568427490
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorNo
NPI enumeratedApril 20, 2006
Last updated in NPPESDecember 10, 2018
Mailing address1615 Petroglyph Point Dr, Prescott, AZ 86301-6539

Medicare enrollment

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

Medicare specialtyPLASTIC AND RECONSTRUCTIVE SURGERY
Medical schoolWRIGHT STATE UNIVERSITY BOONSHOFT SCHOOL OF MEDICINE
Graduated 1988 (38 years in practice)
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

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