Basic Information
Provider Information
NPI: 1649673401
EntityType: 2
ReplacementNPI:  
OrganizationName: MARION COUNTY EMERGENCY PHYSICIANS INC
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Mailing Information
Address1: 4750 HEMPSTEAD STATION DR
Address2:  
City: KETTERING
State: OH
PostalCode: 454295164
CountryCode: US
TelephoneNumber: 8008750136
FaxNumber: 9376194150
Practice Location
Address1: 1000 MCKINLEY PARK DR
Address2:  
City: MARION
State: OH
PostalCode: 433026399
CountryCode: US
TelephoneNumber: 7403838700
FaxNumber: 9376194150
Other Information
ProviderEnumerationDate: 10/07/2014
LastUpdateDate: 10/07/2014
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AuthorizedOfficialLastName: COLE
AuthorizedOfficialFirstName: WILLIAM
AuthorizedOfficialMiddleName: A
AuthorizedOfficialTitleorPosition: CEO
AuthorizedOfficialTelephone: 8008750136
IsSoleProprietor:  
IsOrganizationSubpart: N
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AuthorizedOfficialNameSuffix: JR.
AuthorizedOfficialCredential: MD
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207P00000X  Y193400000X SINGLE SPECIALTY GROUPAllopathic & Osteopathic PhysiciansEmergency Medicine 

No ID Information.


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