Healthcare Provider Details

I. General information

NPI: 1023647500
Provider Name (Legal Business Name): MR. MARCUS ALLEN STRIPLING
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/06/2020
Last Update Date: 10/04/2023
Certification Date: 10/04/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

417 W 3RD AVE
ALBANY GA
31701-1943
US

IV. Provider business mailing address

842 RADICK DR
SAVANNAH GA
31406-3227
US

V. Phone/Fax

Practice location:
  • Phone: 229-312-1000
  • Fax:
Mailing address:
  • Phone: 912-344-8386
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number97116
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: