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NPI 1972203479

NPI 1972203479 : JAMES JOHN MARSH VI MD : JBSA-FORT SAM HOUSTON, TX

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General NPI Number Information
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    NPI Number           |    1972203479
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    Entity Type          |    Individual 
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    Provider Name        |    JAMES JOHN MARSH VI MD
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    Gender               |    Male 
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Dates
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    Enumeration Date     |    03/06/2023
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    Last Update Date     |    10/29/2024
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Provider Practice Location Address
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    Address Line         |    3551 ROGER BROOKE DR. 
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    City                 |    JBSA-FORT SAM HOUSTON
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    State                |    TX
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    Zip                  |    78234-4504
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    Country              |    US
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    Telephone            |    210-916-5910
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    3551 ROGER BROOKE DR. 
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    City                 |    JBSA-FORT SAM HOUSTON
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    State                |    TX
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    Zip                  |    78234-4504
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    Country              |    US
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    Telephone            |    
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    Fax                  |    
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Authorized Official
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    Title or Position    |    
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    Name                 |        
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    Credential           |    
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    Telephone            |    
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    208D00000X
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    Taxonomy Name        |    General Practice Physician
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    License Number       |    0101283978
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    License Number State |    VA
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