Provider Demographics
NPI:1508362948
Name:MARLEY, MACKENZIE BRYNNE (DO)
Entity Type:Individual
Prefix:
First Name:MACKENZIE
Middle Name:BRYNNE
Last Name:MARLEY
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:605 N CLEVELAND MASSILLON RD STE A
Mailing Address - Street 2:
Mailing Address - City:AKRON
Mailing Address - State:OH
Mailing Address - Zip Code:44333-2200
Mailing Address - Country:US
Mailing Address - Phone:330-668-6545
Mailing Address - Fax:330-668-2726
Practice Address - Street 1:605 N CLEVELAND MASSILLON RD STE A
Practice Address - Street 2:
Practice Address - City:AKRON
Practice Address - State:OH
Practice Address - Zip Code:44333-2200
Practice Address - Country:US
Practice Address - Phone:330-668-6545
Practice Address - Fax:330-668-2726
Is Sole Proprietor?:No
Enumeration Date:2018-04-04
Last Update Date:2022-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
OH34.015894207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program