Provider Demographics
NPI:1174597546
Name:MARQUEZ, OBADIAS (MD)
Entity type:Individual
Prefix:DR
First Name:OBADIAS
Middle Name:
Last Name:MARQUEZ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6059 ARBURY WAY STE 101
Mailing Address - Street 2:
Mailing Address - City:OOLTEWAH
Mailing Address - State:TN
Mailing Address - Zip Code:37363-5001
Mailing Address - Country:US
Mailing Address - Phone:423-238-8880
Mailing Address - Fax:423-238-8881
Practice Address - Street 1:6059 ARBURY WAY STE 101
Practice Address - Street 2:
Practice Address - City:OOLTEWAH
Practice Address - State:TN
Practice Address - Zip Code:37363
Practice Address - Country:US
Practice Address - Phone:423-238-8880
Practice Address - Fax:423-238-8881
Is Sole Proprietor?:No
Enumeration Date:2006-02-14
Last Update Date:2020-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN39877207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
H60155Medicare UPIN
3330775Medicare ID - Type Unspecified