MEDICARE: MARCIA D EBBS MD PSC

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	207Q00000X	Family Medicine Physician	30727	KY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	0100865	OTHER		UHC
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	000052153D	OTHER	KY	HUMANA - NCMA
4	118157	OTHER	KY	SIHO - NICC
5	50027441	OTHER	KY	PASSPORT - NCMA
6	019456	OTHER	KY	SIHO - NCMA
7	6935264	OTHER	KY	CIGNA - NCMA
8	000000644690	OTHER	KY	ANTHEM - NCMA
9	000000675746	OTHER	KY	ANTHEM - NICC

General Provider Information

NPI Number	:	1649359514
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARCIA D EBBS MD PSC

Provider Business Mailing Address
First Line	:	1006 NEW MOODY LN
Second Line	:
City	:	LA GRANGE
State	:	KY
Zip	:	40031-9122
Country	:	US
Telephone Number	:	502-593-0083
Fax Number	:	502-222-0029

Provider Business Practice Location Address
First Line	:	1006 NEW MOODY LN
Second Line	:
City	:	LA GRANGE
State	:	KY
Zip	:	40031-9122
Country	:	US
Telephone Number	:	502-593-0083
Fax Number	:	502-222-0029

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

Provider Enumeration Date	:	11/03/2006
Last Update Date	:	05/27/2013

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