Organization
MR. JOSEPH T MARCIN, JR
Active
Parent organization
MR. JOSEPH T. MARCIN, JR
Organization subpart
Yes
Provider details
NPI number
Legal business name
MR. JOSEPH T. MARCIN, JR
Authorized official
MR. JOSEPH THOMAS MARCIN JR. OD (OWNER)
(217) 562-2432
Entity
Organization
Contact information
Practice address
120 S LOCUST ST, PANA, IL 62557-1430
(217) 562-2432
(217) 562-2446
Mailing address
PO BOX 230, PANA, IL 62557-0230
(217) 562-2432
(217) 562-2446
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
046007210
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
410006290
RAILROAD MEDICARE/PALMETTO GBA
IL
Enumeration date
03/17/2009
Last updated
03/18/2009
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