Individual
DR. MARCUS Q. POLK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
76 HIGHLAND PAVILION CT STE 133, HIRAM, GA 30141-3170
(800) 533-8210
(404) 745-8013
Mailing address
PO BOX 370160, DECATUR, GA 30037-0160
(404) 403-4567
(404) 920-8185
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
040758
GA
208VP0014X
Interventional Pain Medicine Physician
040758
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00820036A
—
GA
01
—
050067085
RAILROAD MEDICARE
GA
Enumeration date
11/16/2005
Last updated
08/09/2024
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