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General NPI Number Information
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NPI Number | 1265466791
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Entity Type | Individual
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Provider Name | MARCUS ALI THORNE MD
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Gender | Male
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Dates
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Enumeration Date | 07/10/2006
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Last Update Date | 01/02/2021
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Provider Practice Location Address
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Address Line | 421 E VAN TREES ST
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City | WASHINGTON
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State | IN
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Zip | 47501-2948
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Country | US
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Telephone | 812-254-2663
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 760
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City | WASHINGTON
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State | IN
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Zip | 47501-0760
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Country | US
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Telephone | 812-254-7310
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Fax | 812-257-8602
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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 | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number | 01060526A
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License Number State | IN
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