Organization
CARDIOVASCULAR CONSULTANTS OF MARION PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GARY ALLEN FRICK DO (OWNER)
(765) 651-9347
Entity
Organization
Contact information
Practice address
1123 N WESTERN AVE, MARION, IN 46952-2501
(765) 651-9347
(765) 651-9346
Mailing address
1123 N WESTERN AVE, MARION, IN 46952-2501
(765) 651-9347
(765) 651-9346
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
02001087A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100370010
—
IN
Enumeration date
02/04/2015
Last updated
02/04/2015
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