MEDICARE: DR. MICHAEL A MARSH M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Y00000X	Otolaryngology Physician	C8388	AR

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1174547988
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MICHAEL A MARSH M.D.

Provider Business Mailing Address
First Line	:	7805 PHOENIX AVE
Second Line	:
City	:	FORT SMITH
State	:	AR
Zip	:	72903
Country	:	US
Telephone Number	:	479-242-4220
Fax Number	:	479-242-4221

Provider Business Practice Location Address
First Line	:	7805 PHOENIX AVE
Second Line	:
City	:	FORT SMITH
State	:	AR
Zip	:	72903-5091
Country	:	US
Telephone Number	:	479-242-4220
Fax Number	:	479-242-4221

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/26/2006
Last Update Date	:	07/05/2022

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