Provider Demographics
NPI:1629174164
Name:MARION SLEEP DIAGNOSTICS
Entity Type:Organization
Organization Name:MARION SLEEP DIAGNOSTICS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:DEREK
Authorized Official - Middle Name:E
Authorized Official - Last Name:DENMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:901-372-0923
Mailing Address - Street 1:200 E MILITARY RD
Mailing Address - Street 2:SUITE 2
Mailing Address - City:MARION
Mailing Address - State:AR
Mailing Address - Zip Code:72364-1811
Mailing Address - Country:US
Mailing Address - Phone:870-739-4244
Mailing Address - Fax:870-739-4418
Practice Address - Street 1:200 E MILITARY RD
Practice Address - Street 2:SUITE 2
Practice Address - City:MARION
Practice Address - State:AR
Practice Address - Zip Code:72364-1811
Practice Address - Country:US
Practice Address - Phone:870-739-4244
Practice Address - Fax:870-739-4418
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-15
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR291U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory