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General NPI Number Information
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NPI Number | 1134172208
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Entity Type | Individual
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Provider Name | DR. PATTI JO MARCUM
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Gender | Female
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Dates
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Enumeration Date | 05/18/2006
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Last Update Date | 01/30/2025
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Provider Practice Location Address
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Address Line | 7718 COUNTY ROAD 107
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City | PROCTORVILLE
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State | OH
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Zip | 45669-7928
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Country | US
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Telephone | 740-886-1150
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Fax | 408-861-1777
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Provider Business Mailing Address
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Address Line | 1448 10TH AVENUE SUITE 304
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City | HUNTINGTON
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State | WV
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Zip | 25701-3579
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Country | US
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Telephone | 304-691-6381
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Fax | 304-691-8591
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 21026
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License Number State | WV
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 35.133829
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License Number State | OH
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