Healthcare Provider Details

I. General information

NPI: 1285676999
Provider Name (Legal Business Name): JOHN WILLIS MARSHALL MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/10/2006
Last Update Date: 09/07/2026
Certification Date: 09/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2333 MCCALLIE AVE
CHATTANOOGA TN
37404-3258
US

IV. Provider business mailing address

580 PINE HILL RD
MC DONALD TN
37353-5463
US

V. Phone/Fax

Practice location:
  • Phone: 423-493-1493
  • Fax: 423-698-6061
Mailing address:
  • Phone: 423-902-7737
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number45877
License Number StateGA
# 2
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number30691
License Number StateTN
# 3
Primary TaxonomyN
Taxonomy Code207PE0004X
TaxonomyEmergency Medical Services (Emergency Medicine) Physician
License Number30691
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: