=====================================================
General NPI Number Information
=====================================================
NPI Number | 1104008705
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | WILLIAM M. MARSH, MD, PC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 12/05/2007
-----------------------------------------------------
Last Update Date | 05/13/2014
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 20201 N SCOTTSDALE HEALTHCARE DR SUITE 290
-----------------------------------------------------
City | SCOTTSDALE
-----------------------------------------------------
State | AZ
-----------------------------------------------------
Zip | 85255-4134
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 480-585-0880
-----------------------------------------------------
Fax | 480-585-0882
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 20201 N SCOTTSDALE HEALTHCARE DR SUITE 290
-----------------------------------------------------
City | SCOTTSDALE
-----------------------------------------------------
State | AZ
-----------------------------------------------------
Zip | 85255-4134
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 480-585-0880
-----------------------------------------------------
Fax | 480-585-0882
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OFFICE MANAGER
-----------------------------------------------------
Name | JULIE WILKINSON
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 480-585-0880
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 208D00000X
-----------------------------------------------------
Taxonomy Name | General Practice Physician
-----------------------------------------------------
License Number | 13237
-----------------------------------------------------
License Number State | AZ
-----------------------------------------------------