Provider Demographics
NPI:1164422697
Name:APPLE, MARC G (MD)
Entity Type:Individual
Prefix:
First Name:MARC
Middle Name:G
Last Name:APPLE
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:1451 OLD WEISGARBER RD., SUITE 250
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37909
Mailing Address - Country:US
Mailing Address - Phone:865-862-1625
Mailing Address - Fax:865-321-4558
Practice Address - Street 1:1451 OLD WEISGARBER RD., SUITE 250
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37909
Practice Address - Country:US
Practice Address - Phone:865-862-1625
Practice Address - Fax:865-321-4558
Is Sole Proprietor?:Yes
Enumeration Date:2005-07-27
Last Update Date:2021-08-19
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IN01048136A2085R0001X
GA0727382085R0001X
FLME630282085R0001X
TN635722085R0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0001XAllopathic & Osteopathic PhysiciansRadiologyRadiation Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN200159030Medicaid
OH2055681Medicaid
IN000000614686OtherANTHEM PIN
MI103434926Medicaid
IN920004267OtherMEDICARE RAILROAD
MI104239031Medicaid
MI104239031Medicaid
IN200159030Medicaid
IN920004267Medicare PIN