Individual
DR. BLAKE M MARSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1122 COMMONS AVE, CORTLAND, NY 13045-1643
(607) 428-8004
(607) 428-8003
Mailing address
1301 TRUMANSBURG RD, SUITE P, ITHACA, NY 14850-1397
(607) 277-2365
(607) 277-1415
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
219213
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02099829
—
NY
Enumeration date
04/03/2006
Last updated
07/01/2016
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