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General NPI Number Information
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NPI Number | 1548308232
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Entity Type | Organization
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Legal Business Name | DR W E MARSHALL AND DR J C MARSHALL OPTOMETRISTS INC
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Dates
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Enumeration Date | 02/02/2007
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Last Update Date | 02/19/2008
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Provider Practice Location Address
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Address Line | 1990 N ARLINGTON AVE
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City | INDIANAPOLIS
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State | IN
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Zip | 46218-5128
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Country | US
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Telephone | 317-357-8534
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Fax | 317-322-7794
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Provider Business Mailing Address
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Address Line | 1990 N ARLINGTON AVE
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City | INDIANAPOLIS
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State | IN
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Zip | 46218-5128
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Country | US
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Telephone | 317-357-8534
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Fax | 317-322-7794
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Authorized Official
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Title or Position | OWNER
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Name | DR. JEFFREY C MARSHALL
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Credential | O.D.
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Telephone | 317-357-8534
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 18001561B
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License Number State | IN
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