Provider Demographics
NPI:1700851946
Name:MARLON, ANTHONY MATTHEW (MD)
Entity Type:Individual
Prefix:
First Name:ANTHONY
Middle Name:MATTHEW
Last Name:MARLON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1645 VILLAGE CENTER CIR STE 141
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89134-6371
Mailing Address - Country:US
Mailing Address - Phone:702-834-7333
Mailing Address - Fax:702-834-7337
Practice Address - Street 1:1645 VILLAGE CENTER CIR STE 141
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89134-6371
Practice Address - Country:US
Practice Address - Phone:702-834-7333
Practice Address - Fax:702-834-7337
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-21
Last Update Date:2011-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV2625207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease