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Organization
MARION DIAGNOSTIC CENTER, LLC
Active
Organization
MARION DIAGNOSTIC CENTER, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JAY CARTER (OFFICE ADMINISTRATOR)
(618) 993-1400
Entity
Organization
Contact information
Practice address
3003 CIVIC CIRCLE BLVD SUITE 200, MARION, IL 62959-5259
(618) 993-1400
(618) 993-1522
Mailing address
3003 CIVIC CIRCLE BLVD SUITE 200, MARION, IL 62959-5259
(618) 993-1400
(618) 993-1522
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
—
NULL
207P00000X
Emergency Medicine Physician
—
—
207Q00000X
Family Medicine Physician
—
NULL
207Q00000X
Family Medicine Physician
—
—
207RG0100X
Gastroenterology Physician
—
NULL
207RG0100X
Gastroenterology Physician
—
—
207RH0003X
Hematology & Oncology Physician
—
NULL
207RH0003X
Hematology & Oncology Physician
—
—
207V00000X
Obstetrics & Gynecology Physician
—
NULL
207V00000X
Obstetrics & Gynecology Physician
—
—
207Y00000X
Otolaryngology Physician
—
NULL
207Y00000X
Otolaryngology Physician
—
—
208000000X
Pediatrics Physician
—
NULL
208000000X
Pediatrics Physician
—
—
208600000X
Surgery Physician
—
NULL
208600000X
Surgery Physician
—
—
208800000X
Urology Physician
—
NULL
208800000X
Urology Physician
—
—
213E00000X
Podiatrist
—
NULL
213E00000X
Podiatrist
—
—
261QM1300X
Multi-Specialty Clinic/Center
Primary
—
NULL
261QR0200X
Radiology Clinic/Center
—
NULL
261QR1300X
Rural Health Clinic/Center
—
NULL
363A00000X
Physician Assistant
—
NULL
363A00000X
Physician Assistant
—
—
363L00000X
Nurse Practitioner
—
NULL
363L00000X
Nurse Practitioner
—
—
Other
Enumeration date
09/26/2006
Last updated
09/08/2022
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