Organization
MARION OCCUPATIONAL MEDICINE LLC
Active
Other names
Marion Primary Care
Organization subpart
No
Provider details
NPI number
Authorized official
GARDNER BARTRUM (CEO)
(765) 664-9000
Entity
Organization
Contact information
Practice address
1614 N BALDWIN AVE, MARION, IN 46952-1437
(765) 664-9000
Mailing address
1614 N BALDWIN AVE, MARION, IN 46952-1437
(765) 664-9000
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
201015960
—
IN
Enumeration date
01/04/2011
Last updated
07/13/2015
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