Provider Demographics
NPI:1366738825
Name:MARLER, GORDON (DO)
Entity type:Individual
Prefix:
First Name:GORDON
Middle Name:
Last Name:MARLER
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:6847 N CHESTNUT ST
Mailing Address - Street 2:SUITE 200
Mailing Address - City:RAVENNA
Mailing Address - State:OH
Mailing Address - Zip Code:44266-3929
Mailing Address - Country:US
Mailing Address - Phone:330-296-9606
Mailing Address - Fax:330-297-8830
Practice Address - Street 1:6847 N CHESTNUT ST
Practice Address - Street 2:SUITE 200
Practice Address - City:RAVENNA
Practice Address - State:OH
Practice Address - Zip Code:44266-3929
Practice Address - Country:US
Practice Address - Phone:330-296-9606
Practice Address - Fax:330-297-9835
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-23
Last Update Date:2015-06-10
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
OH34-010813207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine