Mark Edward Fenzl, D.O.
Individual provider Active NPI General Practice Physician · Forest, OH
NPI 1790993137 · NPPES record last updated May 26, 2009
Key facts
- NPI
- 1790993137
- Entity type
- Individual (NPI type 1)
- Primary specialty
- General Practice Physician 208D00000X
- License
- 34.008871 (OH)
- Practice address
- 216 E Lima St
Forest, OH 45843-1118 - Phone
- (419) 273-2553
- Fax
- (419) 273-3337
- NPI assigned
- May 18, 2007
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- HHS exclusion list flag
- The National Provider Directory flags this NPI as appearing on an HHS exclusion list.
- Credentials
- Doctor of Osteopathy
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Floyd County Memorial Hospital Commission | Past | Accepting new patients | |
| Lima Memorial Joint Operating Company | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Physician | 208D00000X | 34.008871 | OH | Yes |
Addresses
Primary practice location
216 E Lima St
Forest, OH 45843-1118
Mailing address
216 E Lima St
Forest, OH 45843-1118
Phone (419) 273-2553
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| P00681969 | Other | OH | RAILROAD CARE |
| 2902854 | Medicaid | OH |
Other providers in Forest, OH
- Briana Digby
- Bobbijo I Drumm
- Jennifer Marie Frey
- Kathy Garman
- Jackson Forest Emergency Ambulance Service
- Jessika King
- Kelly Melroy
All providers in Forest, OH · General Practice Physician in Ohio
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 26, 2009. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.