MRS. MARLA D CARLISLE PA-C NPI 1316260839

NPI Information

NPI: 1316260839
Provider Name: MRS. MARLA D CARLISLE, PA-C
Classification: Physician Assistant - 363AM0700X
Entity Type: Individual

Specialization: Medical

PECOS Registration: Yes

Address:
605 THIRD AVENUE, SUITE B
FREMONT, OH
ZIP 43420
Phone: (567) 201-2890
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MRS. Marla D Carlisle, PA-C is a medical physician assistant in Fremont, OH with 15 years of experience. MRS. Marla D Carlisle, PA-C NPI is 1316260839. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

605 THIRD AVENUE, SUITE B
FREMONT, OH
ZIP 43420
Phone: (567) 201-2890

The NPI 1316260839 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 3/11/2010 and was last updated on 10/7/2016.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	363AM0700X	Physician Assistant	Medical	5601006448	MICHIGAN	No
2	363AM0700X	Physician Assistant	Medical	50.003055	OHIO	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State
1	PA35641	MEDICARE PIN	OHIO
2	H422920	MEDICARE PIN	OHIO
3	0071368	MEDICAID	OHIO
4	P01618687	MEDICARE PIN	OHIO

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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