Healthcare Provider Details

I. General information

NPI: 1023100526
Provider Name (Legal Business Name): JOHN EVERETT MARSHALL MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/29/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

104 LINCOLN MEDICAL PARK
LINCOLNTON NC
28092-4402
US

IV. Provider business mailing address

104 LINCOLN MEDICAL PARK 1446 GASTON ST.
LINCOLNTON NC
28092-4402
US

V. Phone/Fax

Practice location:
  • Phone: 704-735-4445
  • Fax: 704-735-4060
Mailing address:
  • Phone: 704-735-4445
  • Fax: 704-735-4060

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207QA0505X
TaxonomyAdult Medicine Physician
License Number39646
License Number StateNC
# 2
Primary TaxonomyN
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number39646
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: