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NPI Code Detail

MEDICARE: DR. MARVIN FRANKLIN PIBURN JR. MD

MEDICARE: DR. MARVIN FRANKLIN PIBURN JR. MD
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
12084P0800XPsychiatry Physician19792IA

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 : 1285681528
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. MARVIN FRANKLIN PIBURN JR. MD
Provider Business Mailing Address
First Line : 2277 IOWA AVE
Second Line :
City : INDEPENDENCE
State : IA
Zip : 50644-9106
Country : US
Telephone Number : 319-334-2583
Fax Number : 319-334-5252
Provider Business Practice Location Address
First Line : 2277 IOWA AVE
Second Line :
City : INDEPENDENCE
State : IA
Zip : 50644-9106
Country : US
Telephone Number : 319-334-2583
Fax Number : 319-334-5252
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/30/2006
Last Update Date : 03/15/2026

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