Marc O Wall


Address: 230 E Ave, Cedartown, GA 30125-3002

Marc O Wall (NPI# 1376797134, PAC ID# 1951562057) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is FAMILY MEDICINE.

Physician Overview

Nation Provider ID (NPI) 1376797134
PAC ID by PECOS 1951562057
Professional Enrollment ID I20120417000719
Full Name Marc O Wall
Address 230 E Ave
Cedartown
GA 30125-3002
Gender M
Medical School MEDICAL COLLEGE OF GEORGIA
Graduation Year 1984
Primary Specialty FAMILY MEDICINE
Accepts Medicare Assignment Y

Claims Based Hospital Affiliation

Claim Control Number (CCN) Legal Business Name
111330 POLK MEDICAL CENTER
110054 FLOYD MEDICAL CENTER

Other Locations

Address Phone Organization
230 E Ave, Cedartown, GA 30125-3002

Organization Information

Office Location

Street Address 230 E AVE
City CEDARTOWN
State GA
Zip 30125-3002

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Competitor

Search similar physicians

City CEDARTOWN
Zip Code 30125
Specialty FAMILY MEDICINE
City + Specialty CEDARTOWN + FAMILY MEDICINE

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS)
Jurisdiction Medicare

This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.

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