Provider Demographics
NPI:1285736728
Name:WEST MARION FAMILY MEDICINE, PA
Entity type:Organization
Organization Name:WEST MARION FAMILY MEDICINE, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:STEPHANIE
Authorized Official - Middle Name:R
Authorized Official - Last Name:WALKER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:352-873-6044
Mailing Address - Street 1:4600 SW 46TH CT
Mailing Address - Street 2:BLDG 200 STE 160
Mailing Address - City:OCALA
Mailing Address - State:FL
Mailing Address - Zip Code:34474-5708
Mailing Address - Country:US
Mailing Address - Phone:352-873-6044
Mailing Address - Fax:352-873-7189
Practice Address - Street 1:4600 SW 46TH CT
Practice Address - Street 2:BLDG 200 STE 160
Practice Address - City:OCALA
Practice Address - State:FL
Practice Address - Zip Code:34474-5708
Practice Address - Country:US
Practice Address - Phone:352-873-6044
Practice Address - Fax:352-873-7189
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-04
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
K6112Medicare ID - Type Unspecified