| Doctor Name: | MARCIAL Q FAVILA |
| NPI Number: | 1104892751 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | MD |
| License Number: | 1566882 |
| Business Practice Address: | 650 Joel Drive Blanchfield Army Community Hospital Fort Campbell, KY - 422235349 |
| Business Phone Number: | 2707988372 |
| Business Fax Number: | 2709560180 |
| Mailing Address: | 650 Joel Drive, Blanchfield Army Community Hospital FORT CAMPBELL |
| State: | KY |
| Postal Code: | 422235349 |
| Phone Number: | 2707988372 |
| Fax Number: | 2709560180 |
| NPI Enumeration Date: | 02/24/2006 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 2085R0202X |
| License Number: | 1566882 |
| Healthcare Provider Taxonomy: (Secondary) | X |
| State: | FL |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | Radiology |
| Taxonomy Specialization: | Diagnostic Radiology |
| Taxonomy Definition: | A radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease. |