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David W. Marden
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NPI Number Detailed Information
Provider Information:
| Name: | David W. Marden |
| Gender: | M |
| Provider License Number If Given: | DO 1214 |
NPI Information:
| NPI: | 1699778605 |
| Entity Type (Individual or Organization): |
1-ind |
| Enumeration Date: | 5/23/2005 |
| Last Update Date: | 11/30/2016 |
Provider Business Mailing Address:
| Address: | 1 MEDICAL PARK BLVD STE 305E Bristol, TN 37620 |
| Phone Number: | 4238445640 |
| Fax Number: | 4238445645 |
Provider Business Practice Location Address:
| Address: | 1 MEDICAL PARK BLVD STE 305E Bristol, TN 37620 |
| Phone Number: | 4238445640 |
| Fax Number: | 4238445645 |
Provider Taxonomy:
| Primary: | 207V00000X |
| Secondary (if any): | |
| State: | TN |
