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NPI Code Detail

MEDICARE: JOHN D MARSHALL MD

MEDICARE: JOHN D 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
1208D00000XGeneral Practice Physician10961AZ
2207Q00000XFamily Medicine Physician10961AZ

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
11Z1830OTHERAZHEALTHNET PROVIDER ID
2AZ0722270OTHERAZBCBS PROVIDER ID

General Provider Information

NPI Number : 1780761916
Entity Type Code : Individual
Provider Name (Legal Business Name) : JOHN D MARSHALL MD
Provider Business Mailing Address
First Line : 3811 E BELL RD
Second Line : STE 107
City : PHOENIX
State : AZ
Zip : 85032-2158
Country : US
Telephone Number : 602-482-6100
Fax Number : 602-992-6424
Provider Business Practice Location Address
First Line : 3811 E BELL RD STE 106
Second Line :
City : PHOENIX
State : AZ
Zip : 85032-2158
Country : US
Telephone Number : 602-482-6100
Fax Number : 602-992-6424
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/01/2006
Last Update Date : 09/26/2018

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Directions to “ JOHN D MARSHALL MD” Practice Location

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