Organization
MARIETTA GYNECOLOGIC ASSOCIATES, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. KAREN E LINES (PRACTICE ADMINSTRATOR)
(740) 374-3622
Entity
Organization
Contact information
Practice address
410 2ND ST, MARIETTA, OH 45750-2115
(740) 374-3622
(740) 374-4209
Mailing address
410 2ND ST, MARIETTA, OH 45750-2115
(740) 374-3622
(740) 374-4209
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
N/A
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0006831000
—
OH
05
—
0006831000
—
WV
Enumeration date
11/01/2006
Last updated
01/22/2008
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