Healthcare Provider Details

I. General information

NPI: 1710053061
Provider Name (Legal Business Name): MARION OB GYN INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/28/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1140 INDEPENDENCE AVE
MARION OH
43302-6392
US

IV. Provider business mailing address

1140 INDEPENDENCE AVE
MARION OH
43302-6392
US

V. Phone/Fax

Practice location:
  • Phone: 740-387-2244
  • Fax: 740-382-8667
Mailing address:
  • Phone: 740-387-2244
  • Fax: 740-382-8667

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. DAVID WILLIAM FOULK
Title or Position: MD
Credential: MD
Phone: 740-387-2244