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NPI Code Detail

MEDICARE: MARK SCOTT MARSHALL M.D.

MEDICARE: MARK SCOTT 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
12084P0800XPsychiatry Physician27955CO

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1295735595
Entity Type Code : Individual
Provider Name (Legal Business Name) : MARK SCOTT MARSHALL M.D.
Provider Business Mailing Address
First Line : 4141 E DICKENSON PL
Second Line :
City : DENVER
State : CO
Zip : 80222-6012
Country : US
Telephone Number : 303-504-6509
Fax Number : 303-782-0916
Provider Business Practice Location Address
First Line : 4455 E 12TH AVE
Second Line :
City : DENVER
State : CO
Zip : 80220-2415
Country : US
Telephone Number : 303-504-7700
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/28/2005
Last Update Date : 01/06/2016

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