Marden B Lacuesta MD Inc

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

35043441 Issued in OH

Legal business name

MARDEN B LACUESTA MD INC

Practice address

718 E Wayne St
Celina, OH 45822-1356

Phone

(419) 586-2523

Fax

(419) 584-1617

NPI assigned

Nov 15, 2010

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Marden B Lacuesta, MD

Title

President

Phone

(419) 586-2523

Specialties & licenses 1

Addresses

Other identifiers 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Purchit V Lacuesta, M.D.

  • Family Medicine Physician
  • Chicago, IL
  • NPI 1003887423
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1289779200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1289779200000",
    "number": "1811298342",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "718 E WAYNE ST",
            "city": "CELINA",
            "state": "OH",
            "postal_code": "458221356",
            "telephone_number": "419-586-2523",
            "fax_number": "419-584-1617"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "718 E WAYNE ST",
            "city": "CELINA",
            "state": "OH",
            "postal_code": "458221356",
            "telephone_number": "419-586-2523",
            "fax_number": "419-584-1617"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARDEN B LACUESTA MD INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-11-15",
        "last_updated": "2010-11-15",
        "status": "A",
        "authorized_official_last_name": "LACUESTA",
        "authorized_official_first_name": "MARDEN",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "419-586-2523",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "OH",
            "license": "35043441",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0396905",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Heidi Luebke
• Mallory Lutz, DDS
• Nathaniel Lutz, DDS
• Travis Duane Lutz, DDS
• Majestic Care of Celina LLC
• Kiersten Renee Martin, FNP-C
• Kristina M Martin
• Melinda Martin
• Tim Martin
• Philip R. Masser, M.D.

• Family Medicine Physician in Celina, OH
• Providers in Celina, OH by specialty
• Family Medicine Physician in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.