Basic Information
| Provider Information | |||||||||
| NPI: | 1942267125 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | DEVOL | ||||||||
| FirstName: | MARJORIE | ||||||||
| MiddleName: | DAISY | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 5450 FRANTZ RD STE 360 | ||||||||
| Address2: | |||||||||
| City: | DUBLIN | ||||||||
| State: | OH | ||||||||
| PostalCode: | 430164141 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6145446155 | ||||||||
| FaxNumber: | 6145446370 | ||||||||
| Practice Location | |||||||||
| Address1: | 11 JOHN LLOYD EVANS MEMORIAL DR STE 200 | ||||||||
| Address2: | |||||||||
| City: | NELSONVILLE | ||||||||
| State: | OH | ||||||||
| PostalCode: | 457642523 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7407537323 | ||||||||
| FaxNumber: | 7407537388 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/29/2006 | ||||||||
| LastUpdateDate: | 12/13/2019 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 12/13/2019 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | 35-088119 | OH | Y | Allopathic & Osteopathic Physicians | Family Medicine |
No ID Information.