Provider Demographics
NPI:1689634685
Name:MARION COUNTY HEALTH DEPARTMENT
Entity Type:Organization
Organization Name:MARION COUNTY HEALTH DEPARTMENT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DISTRICT HEALTH DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:ZSOLT
Authorized Official - Middle Name:
Authorized Official - Last Name:KOPPANYI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:706-321-6300
Mailing Address - Street 1:111 A BAKER STREET
Mailing Address - Street 2:
Mailing Address - City:BUENA VISTA
Mailing Address - State:GA
Mailing Address - Zip Code:31803-0404
Mailing Address - Country:US
Mailing Address - Phone:229-649-5664
Mailing Address - Fax:
Practice Address - Street 1:111A BAKER STREET
Practice Address - Street 2:
Practice Address - City:BUENA VISTA
Practice Address - State:GA
Practice Address - Zip Code:31803-0404
Practice Address - Country:US
Practice Address - Phone:229-649-5664
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-03-24
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251K00000XAgenciesPublic Health or Welfare
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA00052082HMedicaid
GA00058726IMedicaid
GA00453164FMedicaid
GA00798091BMedicaid
GA00457729OMedicaid
GA00058726IMedicaid
GA00457729OMedicaid