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General NPI Number Information
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NPI Number | 1891987194
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Entity Type | Individual
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Provider Name | MARCUS EUGENE GENTRY DO
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Gender | Male
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Dates
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Enumeration Date | 08/10/2007
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Last Update Date | 01/26/2023
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Provider Practice Location Address
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Address Line | 364 WHITE OAK ST
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City | ASHEBORO
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State | NC
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Zip | 27203-5434
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Country | US
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Telephone | 336-629-8807
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Fax |
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Provider Business Mailing Address
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Address Line | 853 WELLINGTON PL
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City | ASHEBORO
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State | NC
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Zip | 27205-2132
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Country | US
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Telephone | 336-301-3240
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Fax |
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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 | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | 36116439
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 207PE0004X
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Taxonomy Name | Emergency Medical Services (Emergency Medicine) Physician
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License Number | 200800323
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License Number State | NC
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Taxonomy #3
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | 2008-00323
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License Number State | NC
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