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NPI Code Detail

MEDICARE: MARSHALL L. REA D.O.

MEDICARE: MARSHALL L. REA D.O.
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
1207PE0004XEmergency Medical Services (Emergency Medicine) Physician3412OK

Other Identifiers

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

General Provider Information

NPI Number : 1548256043
Entity Type Code : Individual
Provider Name (Legal Business Name) : MARSHALL L. REA D.O.
Provider Business Mailing Address
First Line : PO BOX 269024
Second Line :
City : OKLAHOMA CITY
State : OK
Zip : 73126-9024
Country : US
Telephone Number : 866-321-8433
Fax Number :
Provider Business Practice Location Address
First Line : 700 LILLY RD NE
Second Line :
City : OLYMPIA
State : WA
Zip : 98506-5115
Country : US
Telephone Number : 360-923-7000
Fax Number : 360-923-7089
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/21/2005
Last Update Date : 04/25/2024

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Directions to “ MARSHALL L. REA D.O.” Practice Location

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