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General NPI Number Information
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NPI Number | 1154517605
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Entity Type | Organization
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Legal Business Name | BOGDAN R MARCOL MD FACS PSC
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Dates
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Enumeration Date | 09/19/2007
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Last Update Date | 09/19/2007
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Provider Practice Location Address
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Address Line | 1216A N RACE ST
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City | GLASGOW
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State | KY
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Zip | 42141-3462
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Country | US
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Telephone | 270-651-8348
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Fax | 270-651-9402
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Provider Business Mailing Address
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Address Line | 1216A N RACE ST
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City | GLASGOW
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State | KY
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Zip | 42141-3462
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Country | US
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Telephone | 270-651-8348
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Fax | 270-651-9402
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | MRS. MYRA G BELCHER
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Credential |
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Telephone | 270-651-8348
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208800000X
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Taxonomy Name | Urology Physician
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License Number | 39240
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License Number State | KY
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