Fagelson, Marc A.

Fagelson, Marc A. is an individual health care provider with primary practice located at 156 S. Dossett Drive , Johnson City TN 37614. He recently has only one registered license in Speech, Language and Hearing Service Providers / Audiologist, which is considered as his primary health care specialty. Fagelson, Marc A. can be contacted via phone (423) 439-4355.

Contact Information

Primary practice address
156 S. Dossett Drive Johnson City TN 37614
Phone: (423) 439-4355
Fax: (423) 439-4607
Website:
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Health care specialties

SpecialtyCodeLicense #State
Speech, Language and Hearing Service Providers / Audiologist 231H00000X 0000001136 Tennessee

Profile Details

NPI number 1760413116
LBN Legal business name Fagelson, Marc A.
Credentials PH.D., CCC-A
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 5th, 2006
Last updated Jan 17th, 2024 - about 2 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1760413116 NPPES
Tennessee MEDICAID 3198223

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