Provider Demographics
NPI:1346393204
Name:MARION GENERAL HOSPITAL
Entity Type:Organization
Organization Name:MARION GENERAL HOSPITAL
Other - Org Name:PEDIATRIC CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:
Authorized Official - First Name:STEPHANIE
Authorized Official - Middle Name:
Authorized Official - Last Name:HILTON-SIEBERT
Authorized Official - Suffix:
Authorized Official - Credentials:FACHE, CPA, FHFMA
Authorized Official - Phone:765-662-4776
Mailing Address - Street 1:330 N WABASH
Mailing Address - Street 2:STE G20
Mailing Address - City:MARION
Mailing Address - State:IN
Mailing Address - Zip Code:46952-2600
Mailing Address - Country:US
Mailing Address - Phone:765-660-7600
Mailing Address - Fax:765-651-7313
Practice Address - Street 1:330 N WABASH AVE
Practice Address - Street 2:SUITE 320
Practice Address - City:MARION
Practice Address - State:IN
Practice Address - Zip Code:46952-2779
Practice Address - Country:US
Practice Address - Phone:765-660-7660
Practice Address - Fax:765-671-3502
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:MARION GENERAL HOSPITAL
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-01-22
Last Update Date:2020-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN100269250Medicaid
IN296260Medicare PIN