Provider Demographics
NPI:1427038710
Name:MARION SPEECH & HEARING CENTER
Entity Type:Organization
Organization Name:MARION SPEECH & HEARING CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:ROGER
Authorized Official - Middle Name:K
Authorized Official - Last Name:WINGER
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:740-383-2513
Mailing Address - Street 1:1199 DELAWARE AVE
Mailing Address - Street 2:STE 101
Mailing Address - City:MARION
Mailing Address - State:OH
Mailing Address - Zip Code:43302-6475
Mailing Address - Country:US
Mailing Address - Phone:740-383-2513
Mailing Address - Fax:740-387-6495
Practice Address - Street 1:1199 DELAWARE AVE
Practice Address - Street 2:STE 101
Practice Address - City:MARION
Practice Address - State:OH
Practice Address - Zip Code:43302-6475
Practice Address - Country:US
Practice Address - Phone:740-383-2513
Practice Address - Fax:740-387-6495
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-01-20
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHSP5253235Z00000X
OHA00072237600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty
Not Answered237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid FitterGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH000000234960OtherANTHEM
OH0135133Medicaid
OH272949609002OtherMEDICAL MUTUAL
OH4600009OtherUNITED HEALTH CARE
OHMA9318871Medicare ID - Type Unspecified