Healthcare Provider Details

I. General information

NPI: 1548824535
Provider Name (Legal Business Name): MARION PAIN CENTER, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/25/2019
Last Update Date: 04/25/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1065 DELAWARE AVE STE A
MARION OH
43302-6461
US

IV. Provider business mailing address

1065 DELAWARE AVE STE A
MARION OH
43302-6461
US

V. Phone/Fax

Practice location:
  • Phone: 740-387-7246
  • Fax: 740-387-7244
Mailing address:
  • Phone: 740-387-7246
  • Fax: 740-387-7244

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State

VIII. Authorized Official

Name: DR. ADIL OMAR KATABAY
Title or Position: OWNER
Credential:
Phone: 740-387-7246