Provider Demographics
NPI:1912234121
Name:MARJON, PHILIP LOUIS (MD)
Entity Type:Individual
Prefix:DR
First Name:PHILIP
Middle Name:LOUIS
Last Name:MARJON
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 1:104 WOODMONT BLVD STE 500
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37205-2245
Mailing Address - Country:US
Mailing Address - Phone:615-783-1066
Mailing Address - Fax:
Practice Address - Street 1:838 NORDAHL RD STE 300
Practice Address - Street 2:
Practice Address - City:SAN MARCOS
Practice Address - State:CA
Practice Address - Zip Code:92069-3599
Practice Address - Country:US
Practice Address - Phone:760-747-8935
Practice Address - Fax:760-466-0078
Is Sole Proprietor?:Yes
Enumeration Date:2009-11-09
Last Update Date:2024-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIMD14130207R00000X
MA253762207RH0003X
CAC175032207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & OncologyGroup - Multi-Specialty
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine