Organization
MARION GENERAL RADIOLOGY, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN DEAN MD (PRESIDENT)
(800) 288-8325
Entity
Organization
Contact information
Practice address
441 N WABASH AVE, MARION, IN 46952-2612
(800) 288-8325
(419) 866-5453
Mailing address
830 N BALDWIN AVE, MARION, IN 46952-2542
(800) 288-8325
(419) 866-5453
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000101047
BC BS
IN
05
—
100282670A
—
IN
05
—
100282670B
—
IN
05
—
100282670C
—
IN
05
—
100282670D
—
IN
Enumeration date
07/19/2005
Last updated
09/19/2018
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