Bacon, Marilyn A
Bacon, Marilyn A is an individual health care provider with primary practice located at 820C Prospect Hill Rd , Windsor CT 06095. She recently has only one registered license in Allopathic & Osteopathic Physicians / Adolescent Medicine, which is considered as her primary health care specialty. Bacon, Marilyn A can be contacted via phone (860) 285-8251.Contact Information
Primary practice address
820C Prospect Hill Rd
Windsor CT 06095
Phone: (860) 285-8251
Fax: (860) 687-1774
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Adolescent Medicine | 2080A0000X | 017505 | Connecticut |
Profile Details
| NPI number | 1659349835 |
|---|---|
| LBN Legal business name | Bacon, Marilyn A |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Mar 14th, 2006 |
| Last updated | Jul 8th, 2007 - about 17 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1659349835 | NPPES |
| Connecticut | Other | 010017505CT02 | ANTHEM BCBS |
| Connecticut | Other | 710294 | ANTHEM BCBS |
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