Justin L Marlar (NPI# 1609165760, PAC ID# 0143470799) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is FAMILY MEDICINE.
| Nation Provider ID (NPI) | 1609165760 |
| PAC ID by PECOS | 0143470799 |
| Professional Enrollment ID | I20121017000474 |
| Full Name | Justin L Marlar |
| Organization Legal Name | EAGLE CREEK EMERGENCY GROUP, PC |
| Address |
301 Tyson Ave Paris TN 38242-4544 |
| Phone Number | 7316421220 |
| Gender | M |
| Medical School | UNIVERSITY OF TENNESSEE COLLEGE OF MEDICINE |
| Graduation Year | 2011 |
| Primary Specialty | FAMILY MEDICINE |
| Secondary Specialties | EMERGENCY MEDICINE |
| Group Practice PAC ID | 2466714571 |
| Number of Group Practice Members | 20 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 040156 | |
| 040118 | NEA BAPTIST MEMORIAL HOSPITAL |
| 250141 | BAPTIST MEMORIAL HOSPITAL DESOTO |
| 440131 | BAPTIST MEMORIAL HOSPITAL TIPTON |
| 440132 | HENRY COUNTY MEDICAL CENTER |
| Address | Phone | Organization |
|---|---|---|
| 4800 E Johnson Ave, Jonesboro, AR 72401-8413 | 8709361000 | SOUTHEASTERN EMERGENCY PHYSICIANS LLC |
| 301 Tyson Ave, Paris, TN 38242-4544 | 7316421220 | EAGLE CREEK EMERGENCY GROUP, PC |
| 7601 Southcrest Pkwy, Southaven, MS 38671-4739 | 6627724000 | SOUTHEASTERN EMERGENCY PHYSICIANS LLC |
| Organization Legal Name | EAGLE CREEK EMERGENCY GROUP, PC |
| Physicians | 14 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Michael E Ort | Emergency Medicine | Eagle Creek Emergency Group, PC | 301 Tyson Ave, Paris, TN 38242-4544 |
| Kevin T Hogan | Emergency Medicine | Eagle Creek Emergency Group, PC | 301 Tyson Ave, Paris, TN 38242-4544 |
| Deline Kirubanathan | Emergency Medicine | Eagle Creek Emergency Group, PC | 301 Tyson Ave, Paris, TN 38242-4544 |
| Teresa Bennett | Nurse Practitioner | Eagle Creek Emergency Group, PC | 301 Tyson Ave, Paris, TN 38242-4544 |
| Randall M Minor | Emergency Medicine | Eagle Creek Emergency Group, PC | 301 Tyson Ave, Paris, TN 38242-4544 |
| Steven Hedlesky | Emergency Medicine | Eagle Creek Emergency Group, PC | 301 Tyson Ave, Paris, TN 38242-4544 |
| Eric John Jacobson | Emergency Medicine | Eagle Creek Emergency Group, PC | 301 Tyson Ave, Paris, TN 38242-4544 |
| Kelly P Morgan | Nurse Practitioner | Eagle Creek Emergency Group, PC | 301 Tyson Ave, Paris, TN 38242-4544 |
| Bruce D Spinzig | Internal Medicine | Eagle Creek Emergency Group, PC | 301 Tyson Ave, Paris, TN 38242-4544 |
| Kristian M Hill Elliott | Nurse Practitioner | Eagle Creek Emergency Group, PC | 301 Tyson Ave, Paris, TN 38242-4544 |
| Street Address |
301 TYSON AVE |
| City | PARIS |
| State | TN |
| Zip | 38242-4544 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Michael E Ort | Emergency Medicine | Eagle Creek Emergency Group, PC | 301 Tyson Ave, Paris, TN 38242-4544 |
| Henry O Garcia | Certified Registered Nurse Anesthetist (crna) | Henry County Medical Center | 301 Tyson Ave, Paris, TN 38242-4544 |
| Meredith Tate Richardson | Certified Registered Nurse Anesthetist (crna) | Henry County Medical Center | 301 Tyson Ave, Paris, TN 38242-4544 |
| John W Beddies | Urology | Henry County Medical Center | 301 Tyson Ave, Paris, TN 38242-4544 |
| Kevin T Hogan | Emergency Medicine | Eagle Creek Emergency Group, PC | 301 Tyson Ave, Paris, TN 38242-4544 |
| Deline Kirubanathan | Emergency Medicine | Eagle Creek Emergency Group, PC | 301 Tyson Ave, Paris, TN 38242-4544 |
| Tammie S Holcomb | Nurse Practitioner | Henry County Medical Center | 301 Tyson Ave, Paris, TN 38242-4544 |
| Andrew L Rice | Certified Registered Nurse Anesthetist (crna) | Henry County Medical Center | 301 Tyson Ave, Paris, TN 38242-4544 |
| Teresa Bennett | Nurse Practitioner | Eagle Creek Emergency Group, PC | 301 Tyson Ave, Paris, TN 38242-4544 |
| Randall M Minor | Emergency Medicine | Eagle Creek Emergency Group, PC | 301 Tyson Ave, Paris, TN 38242-4544 |
| Find all physicians in the same address | |||
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Terrie Haynes | Nurse Practitioner | 1009 E Wood St, Paris, TN 38242-0460 | |
| Donald D Gold Jr. | Psychiatry | 706 E Wood St, Paris, TN 38242-4220 | |
| Lisa H Hubbard | Physician Assistant | Lakeside Health Clinic, P.c | 706 E Wood St, Paris, TN 38242-4220 |
| Charles A Walker | Interventional Pain Management | 707 E Wood St, Paris, TN 38242-4221 | |
| Joshua A Coleman | Optometry | 715 Morton St, Paris, TN 38242-4296 | |
| Thomas E Townsend | Optometry | 715 Morton St, Paris, TN 38242-4296 | |
| Elizabeth Craig | Chiropractic | 1203 E Wood St, Paris, TN 38242-4317 | |
| Don Andrew Sims | Clinical Social Worker | 1117 E Wood St, Paris, TN 38242-4326 | |
| James W Mcgee | Internal Medicine | East Wood Clinic Pllc | 1323 E Wood St, Paris, TN 38242-4421 |
| Philip W Nanney | Family Medicine | East Wood Clinic Pllc | 1323 E Wood St, Paris, TN 38242-4421 |
| Find all physicians in zip 38242 | |||
| City | PARIS |
| Zip Code | 38242 |
| Specialty | FAMILY MEDICINE |
| City + Specialty | PARIS + FAMILY MEDICINE |
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| 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.