Basic Information
Provider Information
NPI: 1679009831
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: MARCH
FirstName: JORDON
MiddleName: KENNETH
NamePrefix: DR.
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 90 JACKSON PIKE
Address2:  
City: GALLIPOLIS
State: OH
PostalCode: 456311560
CountryCode: US
TelephoneNumber: 7404411949
FaxNumber: 7404465982
Practice Location
Address1: 100 JACKSON PIKE
Address2:  
City: GALLIPOLIS
State: OH
PostalCode: 456311560
CountryCode: US
TelephoneNumber: 7404411949
FaxNumber:  
Other Information
ProviderEnumerationDate: 05/10/2017
LastUpdateDate: 12/17/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 12/17/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207ZP0102X35.14365OHN Allopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology
207ZP0102X10964204-1205UTY Allopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology

No ID Information.


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