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NPI Code Detail

MEDICARE: DEBRA LYNN MARSHALL M.D.

MEDICARE: DEBRA LYNN MARSHALL M.D.
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
1207R00000XInternal Medicine Physician32280KY

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
5P00410727OTHERKYRAILROAD MEDICARE

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
12851803000OTHERPAD - NCMA
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3085492OTHERSIHO - NCMA
450015283OTHERPASSPORT - NCMA
6000000514956OTHERKYANTHEM - NCMA

General Provider Information

NPI Number : 1053394544
Entity Type Code : Individual
Provider Name (Legal Business Name) : DEBRA LYNN MARSHALL M.D.
Provider Business Mailing Address
First Line : PO BOX 950202
Second Line :
City : LOUISVILLE
State : KY
Zip : 40295-0202
Country : US
Telephone Number : 502-969-6552
Fax Number : 502-969-3799
Provider Business Practice Location Address
First Line : 825 BARRET AVE
Second Line :
City : LOUISVILLE
State : KY
Zip : 40204-1743
Country : US
Telephone Number : 502-540-7200
Fax Number : 502-540-7207
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/29/2005
Last Update Date : 03/26/2008

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