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General NPI Number Information
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NPI Number | 1992913669
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Entity Type | Organization
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Legal Business Name | MARION OBSTETRICS & GYNECOLOGY, LTD
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Dates
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Enumeration Date | 05/18/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 3331 W DEYOUNG ST SUITE 201
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City | MARION
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State | IL
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Zip | 62959-5896
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Country | US
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Telephone | 618-998-9888
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Fax | 618-993-5951
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Provider Business Mailing Address
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Address Line | 3331 W DEYOUNG ST SUITE 201
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City | MARION
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State | IL
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Zip | 62959-5896
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Country | US
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Telephone | 618-998-9888
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Fax | 618-993-5951
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | LESLIE SOMERS
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Credential |
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Telephone | 618-998-9888
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number |
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License Number State | IL
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