Provider Demographics
NPI:1841999729
Name:GADDY, MARION LOUISE (PHLEBOTOMY)
Entity type:Individual
Prefix:
First Name:MARION
Middle Name:LOUISE
Last Name:GADDY
Suffix:
Gender:F
Credentials:PHLEBOTOMY
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:111 DAVIS ST STE C
Mailing Address - Street 2:
Mailing Address - City:ASHEBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27203-5485
Mailing Address - Country:US
Mailing Address - Phone:336-267-6428
Mailing Address - Fax:336-521-4020
Practice Address - Street 1:111 DAVIS ST STE C
Practice Address - Street 2:
Practice Address - City:ASHEBORO
Practice Address - State:NC
Practice Address - Zip Code:27203-5485
Practice Address - Country:US
Practice Address - Phone:336-267-6428
Practice Address - Fax:336-521-4020
Is Sole Proprietor?:Yes
Enumeration Date:2023-02-28
Last Update Date:2023-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
246RP1900X
NC335E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier
No246RP1900XTechnologists, Technicians & Other Technical Service ProvidersTechnician, PathologyPhlebotomy