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NPI Code Detail

MEDICARE: DR. ROGER WAYNE MARSHALL MD

MEDICARE: DR. ROGER WAYNE 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
1207V00000XObstetrics & Gynecology Physician04-23577KS

General Provider Information

NPI Number : 1558336362
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. ROGER WAYNE MARSHALL MD
Provider Business Mailing Address
First Line : 514 CLEVELAND ST
Second Line :
City : GREAT BEND
State : KS
Zip : 67530-3562
Country : US
Telephone Number : 620-792-2151
Fax Number : 620-793-9399
Provider Business Practice Location Address
First Line : 514 CLEVELAND ST
Second Line :
City : GREAT BEND
State : KS
Zip : 67530-3562
Country : US
Telephone Number : 620-792-2151
Fax Number : 620-793-9399
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/23/2006
Last Update Date : 12/23/2011

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