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NPI Code Detail

MEDICARE: MARVIN FELIPE PINZON DO

MEDICARE:   MARVIN FELIPE PINZON  DO
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
12085R0202XDiagnostic Radiology Physician039658GA

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
2P01064632OTHERGARAILROAD MEDICARE

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1518947522
Entity Type Code : Individual
Provider Name (Legal Business Name) : MARVIN FELIPE PINZON DO
Provider Business Mailing Address
First Line : 2929 WATSON BLVD STE 2
Second Line : PMB 125
City : WARNER ROBINS
State : GA
Zip : 31093-9601
Country : US
Telephone Number : 478-333-3603
Fax Number : 478-333-3685
Provider Business Practice Location Address
First Line : 1601 WATSON BLVD
Second Line : ATTN: RADIOLOGY DEPARTMENT
City : WARNER ROBINS
State : GA
Zip : 31093-3431
Country : US
Telephone Number : 478-333-3603
Fax Number : 478-333-3685
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/18/2006
Last Update Date : 03/03/2021

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Directions to “ MARVIN FELIPE PINZON DO” Practice Location

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