Healthcare Provider Details

I. General information

NPI: 1700314770
Provider Name (Legal Business Name): HOSPITAL CARE CONSULTANTS OF MARION, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/02/2017
Last Update Date: 06/02/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3333 W DEYOUNG ST
MARION IL
62959-5884
US

IV. Provider business mailing address

PO BOX 96348
OKLAHOMA CITY OK
73143-6348
US

V. Phone/Fax

Practice location:
  • Phone: 618-998-7020
  • Fax: 405-609-1466
Mailing address:
  • Phone: 800-962-3303
  • Fax: 405-609-1466

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number
License Number State

VIII. Authorized Official

Name: MR. RON WEISS
Title or Position: CEO
Credential:
Phone: 618-998-7020