Dr James G Marencik, MD | |
645 S Rogers St, Bloomington, IN 47403-2353 | |
(812) 339-1691 | |
(812) 339-8109 |
Full Name | Dr James G Marencik |
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Gender | Male |
Speciality | Psychiatry & Neurology - Psychiatry |
Location | 645 S Rogers St, Bloomington, Indiana |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1043295694 | NPI | - | NPPES |
200261970A | Medicaid | IN |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
2084P0804X | Psychiatry & Neurology - Child & Adolescent Psychiatry | 01051630 (Indiana) | Secondary |
2084P0800X | Psychiatry & Neurology - Psychiatry | 01051630 (Indiana) | Primary |
Entity Name | Centerstone Of Indiana, Inc. |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1992781470 PECOS PAC ID: 9436138427 Enrollment ID: O20040830000711 |
Mailing Address | Practice Location Address |
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Dr James G Marencik, MD 645 S Rogers St, Bloomington, IN 47403-2353 Ph: (812) 339-1691 | Dr James G Marencik, MD 645 S Rogers St, Bloomington, IN 47403-2353 Ph: (812) 339-1691 |
Jonathan Wicks, ATC, LAT, M.ED Psychiatry & Neurology Medicare: Not Enrolled in Medicare Practice Location: 1001 E 17th St, Bloomington, IN 47408 Phone: 812-855-7920 | |
Dr. David Austin Duncan, DO Psychiatry & Neurology Medicare: Medicare Enrolled Practice Location: 2651 E Discovery Pkwy, Bloomington, IN 47408 Phone: 812-353-5630 Fax: 812-353-5441 | |
Alvin Perry Griffith, M.D. Psychiatry & Neurology Medicare: Medicare Enrolled Practice Location: 601 W 2nd St, Bloomington, IN 47403 Phone: 812-353-5603 Fax: 812-353-3451 | |
Marina Bota, MD Psychiatry & Neurology Medicare: Accepting Medicare Assignments Practice Location: 645 S Rogers St, Bloomington, IN 47403 Phone: 812-339-1691 | |
Abdulrahim Ismail, MD Psychiatry & Neurology Medicare: Accepting Medicare Assignments Practice Location: 2651 E Discovery Pkwy, Bloomington, IN 47408 Phone: 812-353-5222 Fax: 812-353-5262 | |
Joel Harold Griffith, MD Psychiatry & Neurology Medicare: Accepting Medicare Assignments Practice Location: 645 S Rogers St, Bloomington, IN 47403 Phone: 812-339-1691 |