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General NPI Number Information
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NPI Number | 1962470401
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Entity Type | Organization
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Legal Business Name | MARION INDEPENDENT PHYSICIANS ASSOCIATION, LLC
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Dates
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Enumeration Date | 03/10/2006
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Last Update Date | 11/29/2007
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Provider Practice Location Address
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Address Line | 125 EXECUTIVE DR SUITE 207
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City | MARION
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State | OH
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Zip | 43302-6285
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Country | US
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Telephone | 740-223-8056
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Fax | 740-223-7095
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Provider Business Mailing Address
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Address Line | 125 EXECUTIVE DR SUITE 207
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City | MARION
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State | OH
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Zip | 43302-6285
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Country | US
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Telephone | 740-223-8056
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Fax | 740-223-7095
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | BRIAN HEMPSTEAD
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Credential |
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Telephone | 740-387-7200
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 291U00000X
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Taxonomy Name | Clinical Medical Laboratory
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License Number |
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License Number State | OH
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