MEDICARE: MARK ALLYN GEORGE

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
1	374U00000X	Home Health Aide

General Provider Information

NPI Number	:	1376968560
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARK ALLYN GEORGE

Provider Business Mailing Address
First Line	:	1205 HART RD
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43223-3834
Country	:	US
Telephone Number	:	614-556-1422
Fax Number	:

Provider Business Practice Location Address
First Line	:	1205 HART RD
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43223-3834
Country	:	US
Telephone Number	:	614-556-1422
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/24/2014
Last Update Date	:	02/24/2014

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Directions to “ MARK ALLYN GEORGE ” Practice Location

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