Healthcare Provider Details

I. General information

NPI: 1043278724
Provider Name (Legal Business Name): CHRISTOPHER PAUL MARSHALL M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/03/2006
Last Update Date: 08/31/2022
Certification Date: 06/16/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

HIGHWAY 86 AT TOPAWA RD
SELLS AZ
85634
US

IV. Provider business mailing address

PO BOX 548
SELLS AZ
85634-0548
US

V. Phone/Fax

Practice location:
  • Phone: 520-383-7200
  • Fax:
Mailing address:
  • Phone: 520-383-7200
  • Fax: 520-383-7404

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number15640
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: