MARLA D CARLISLE, PA-C, Medical FREMONT, OH

Contact Information

MARLA D CARLISLE, PA-C

605 THIRD AVENUE, SUITE B
FREMONT, OH 43420

Phone: 567-201-2890
Fax:
Website:

	Specialty	Taxonomy Code	Specialty Code	Provider Type
	Medical	363AM0700X	97	Physician Assistant

Indicates primary specialty

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NPI Profile & details for MARLA D CARLISLE · (Female)

NPI Number	`1316260839`
Status	Active
Credentials	PA-C (Physician Assistant-Certified)
Entity	Individual
Enumeration date	03/11/2010
Last updated	10/07/2016 - About 10 years ago
Sole proprietor ¹	No
Identifiers	MI License # 5601006448 OH License # 50.003055 OH Medicaid 0071368
Hospital affiliation(s)	DEFIANCE REGIONAL MEDICAL CENTER - (Critical Access) 1200 RALSTON AVENUE DEFIANCE, OH 43512 MEMORIAL HOSPITAL - (Acute Care) 715 SOUTH TAFT AVENUE FREMONT, OH 43420

¹ A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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MARLA D CARLISLE, PA-C – NPI #1316260839Medical

Contact Information

Specialty

Medical

NPI Profile & details for MARLA D CARLISLE · (Female)

Reviews for MARLA D CARLISLE

MARLA D CARLISLE, PA-C – NPI #1316260839
Medical