Individual
JOHN E MARX
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1007 W RUDISILL BLVD, FORT WAYNE, IN 46807-2170
(260) 425-5180
(260) 425-5210
Mailing address
11109 PARKVIEW PLAZA DR # 117, FORT WAYNE, IN 46845-1701
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
01076053A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000001029278
ANTHEM
IN
05
—
201239270
—
IN
01
—
P01761659
RAILROAD MEDICARE
IN
Enumeration date
06/06/2014
Last updated
10/10/2022
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