Healthcare Provider Details

I. General information

NPI: 1154474542
Provider Name (Legal Business Name): MARION GENERAL HOSPITAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/19/2007
Last Update Date: 06/16/2020
Certification Date: 06/16/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

157 W 8TH ST
FAIRMOUNT IN
46928-1012
US

IV. Provider business mailing address

330 N WABASH STE G0
MARION IN
46952-2600
US

V. Phone/Fax

Practice location:
  • Phone: 765-660-7880
  • Fax: 765-382-4490
Mailing address:
  • Phone: 765-660-7600
  • Fax: 765-651-7313

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: STEPHANIE HILTON-SIEBERT
Title or Position: PRESIDENT/CEO
Credential:
Phone: 765-660-7005