Organization Name: | DR. MARNERS CLINIC, LLC |
NPI Number: | 1053643759 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | WES MARNER (OWNER) |
Mailing Address: | 130b N Randolph Ave Eufaula |
State: | AL US |
Postal Code: | 360271631 |
Phone Number: | 3346871973 |
Fax Number: | 3346871972 |
NPI Enumeration Date: | 02/04/2010 |
NPI Last Update Date: | 03/07/2010 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | D0355 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | AL |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |