MEDICARE: DR. JOSEPH CORBETT MARSHALL MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208600000X	Surgery Physician	13928	KY

General Provider Information

NPI Number	:	1043258817
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JOSEPH CORBETT MARSHALL MD

Provider Business Mailing Address
First Line	:	3120 TWIN CIRCLE DR
Second Line	:
City	:	FLOYDS KNOBS
State	:	IN
Zip	:	47119-9714
Country	:	US
Telephone Number	:	812-944-7150
Fax Number	:

Provider Business Practice Location Address
First Line	:	4402 CHURCHMAN AVE
Second Line	:
City	:	LOUISVILLE
State	:	KY
Zip	:	40215-3100
Country	:	US
Telephone Number	:	502-361-6075
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/03/2006
Last Update Date	:	07/08/2007

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