Provider Demographics
NPI:1528099041
Name:MARION GENERAL HOSPITAL
Entity type:Organization
Organization Name:MARION GENERAL HOSPITAL
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:
Authorized Official - First Name:STEPHANIE
Authorized Official - Middle Name:
Authorized Official - Last Name:HILTON-SIEBERT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:765-660-7007
Mailing Address - Street 1:330 NORTH WABASH AVENUE
Mailing Address - Street 2:SUITE G20
Mailing Address - City:MARION
Mailing Address - State:IN
Mailing Address - Zip Code:46952-2600
Mailing Address - Country:US
Mailing Address - Phone:765-662-4133
Mailing Address - Fax:765-651-7313
Practice Address - Street 1:330 N WABASH AVENUE
Practice Address - Street 2:SUITE G20
Practice Address - City:MARION
Practice Address - State:IN
Practice Address - Zip Code:46952-2600
Practice Address - Country:US
Practice Address - Phone:765-660-7600
Practice Address - Fax:765-651-7313
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-05
Last Update Date:2020-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
No207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
No208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Multi-Specialty
No225400000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation PractitionerGroup - Multi-Specialty
No261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent CareGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN100269250Medicaid
IN296260Medicare PIN