Provider Demographics
NPI:1508910597
Name:C. DAVID MARKLE, M.D. P.C.
Entity Type:Organization
Organization Name:C. DAVID MARKLE, M.D. P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SECRETARY
Authorized Official - Prefix:DR
Authorized Official - First Name:AMBER
Authorized Official - Middle Name:H
Authorized Official - Last Name:DRISKELL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:770-948-4455
Mailing Address - Street 1:1605 MULKEY RD
Mailing Address - Street 2:SUITE A
Mailing Address - City:AUSTELL
Mailing Address - State:GA
Mailing Address - Zip Code:30106-1127
Mailing Address - Country:US
Mailing Address - Phone:770-948-4455
Mailing Address - Fax:770-819-8824
Practice Address - Street 1:1605 MULKEY RD
Practice Address - Street 2:SUITE A
Practice Address - City:AUSTELL
Practice Address - State:GA
Practice Address - Zip Code:30106-1127
Practice Address - Country:US
Practice Address - Phone:770-948-4455
Practice Address - Fax:770-819-8824
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-23
Last Update Date:2008-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
GADC7837Medicare PIN
GAGRP006511Medicare PIN