Marencik, James G

Marencik, James G is an individual health care provider with primary practice located at 645 S Rogers St , Bloomington IN 47403-2353. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Child & Adolescent Psychiatry, Allopathic & Osteopathic Physicians / Psychiatry. Allopathic & Osteopathic Physicians / Psychiatry is his primary health care specialty. Marencik, James G can be contacted via phone (812) 339-1691.

Contact Information

Primary practice address
645 S Rogers St Bloomington IN 47403-2353
Phone: (812) 339-1691
Fax: (812) 339-8109
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Child & Adolescent Psychiatry 2084P0804X 01051630 Indiana
Allopathic & Osteopathic Physicians / Psychiatry 2084P0800X 01051630 Indiana

Profile Details

NPI number 1043295694
LBN Legal business name Marencik, James G
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 7th, 2005
Last updated Jun 17th, 2019 - about 5 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1043295694 NPPES
Indiana MEDICAID 200261970A

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