Provider Demographics
NPI:1952330672
Name:BOLIN, MARION GILBERT (MD)
Entity Type:Individual
Prefix:DR
First Name:MARION
Middle Name:GILBERT
Last Name:BOLIN
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:PO BOX 440261
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37244-0261
Mailing Address - Country:US
Mailing Address - Phone:615-329-0570
Mailing Address - Fax:
Practice Address - Street 1:4220 HARDING PIKE
Practice Address - Street 2:DAN RUDY CANCER CENTER
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37205-2005
Practice Address - Country:US
Practice Address - Phone:615-222-6755
Practice Address - Fax:615-222-3567
Is Sole Proprietor?:No
Enumeration Date:2006-07-03
Last Update Date:2012-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNMD00000089392085R0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0001XAllopathic & Osteopathic PhysiciansRadiologyRadiation Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3186944Medicaid
TN3186944Medicare ID - Type Unspecified
TN3186944Medicaid