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General NPI Number Information
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NPI Number | 1790721579
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Entity Type | Organization
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Legal Business Name | MARION ANESTHESIA COMPANY LLC
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Dates
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Enumeration Date | 06/21/2006
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Last Update Date | 05/21/2025
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Provider Practice Location Address
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Address Line | 3003 CIVIC CIRCLE BLVD
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City | MARION
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State | IL
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Zip | 62959-5259
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Country | US
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Telephone | 618-993-1112
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Fax | 618-993-1113
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Provider Business Mailing Address
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Address Line | 3003 CIVIC CIRCLE BLVD
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City | MARION
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State | IL
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Zip | 62959
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Country | US
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Telephone | 618-993-1112
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Fax | 618-993-1113
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MS. BILLIE HUFF
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Credential |
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Telephone | 618-993-1112
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number | 209001163
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License Number State | IL
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