1043237639 NPI number — DR. MARGUERITE S SCHABELL MD

Table of content: DR. MARGUERITE S SCHABELL MD (NPI 1043237639)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1043237639 NPI number — DR. MARGUERITE S SCHABELL MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
SCHABELL
Provider First Name:
MARGUERITE
Provider Middle Name:
S
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
MD
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1043237639
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
05/19/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1955 DIXIE HIGHWAY
Provider Second Line Business Mailing Address:
SUITE D
Provider Business Mailing Address City Name:
FT. WRIGHT
Provider Business Mailing Address State Name:
KY
Provider Business Mailing Address Postal Code:
41011
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
859-341-5757
Provider Business Mailing Address Fax Number:
859-331-4757

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1955 DIXIE HIGHWAY
Provider Second Line Business Practice Location Address:
SUITE D
Provider Business Practice Location Address City Name:
FT. WRIGHT
Provider Business Practice Location Address State Name:
KY
Provider Business Practice Location Address Postal Code:
41011
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
859-341-5757
Provider Business Practice Location Address Fax Number:
859-331-4757
Provider Enumeration Date:
07/17/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207Q00000X , with the licence number:  27485 , registered in the state of KY ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 2388063 , issued by the state of ( OH ) . This identifiers is of the category "MEDICAID".
  • Identifier: 64274855 , issued by the state of ( KY ) . This identifiers is of the category "MEDICAID".




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