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NPI Code Detail

MEDICARE: MARSHON WHITLEY LCDCIII

MEDICARE:   MARSHON  WHITLEY  LCDCIII
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YA0400XAddiction (Substance Use Disorder) Counselor981010OH

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1003328063
Entity Type Code : Individual
Provider Name (Legal Business Name) : MARSHON WHITLEY LCDCIII
Provider Business Mailing Address
First Line : 665 W MARKET ST
Second Line :
City : AKRON
State : OH
Zip : 44303-1438
Country : US
Telephone Number : 330-379-3467
Fax Number : 330-379-3465
Provider Business Practice Location Address
First Line : 665 W MARKET ST
Second Line :
City : AKRON
State : OH
Zip : 44303-1438
Country : US
Telephone Number : 330-379-3467
Fax Number : 330-379-3465
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/31/2017
Last Update Date : 10/31/2017

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Directions to “ MARSHON WHITLEY LCDCIII” Practice Location

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