Healthcare Provider Details

I. General information

NPI: 1306006341
Provider Name (Legal Business Name): RICHARD H MARSHALL JR. MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/12/2008
Last Update Date: 08/17/2021
Certification Date: 08/17/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2000 CANAL ST
NEW ORLEANS LA
70112-3018
US

IV. Provider business mailing address

1542 TULANE AVE STE 353
NEW ORLEANS LA
70112-2865
US

V. Phone/Fax

Practice location:
  • Phone: 504-702-3309
  • Fax: 504-702-3260
Mailing address:
  • Phone: 504-568-4647
  • Fax: 504-568-8955

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085R0204X
TaxonomyVascular & Interventional Radiology Physician
License NumberMD.203790
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: