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NPI Code Detail

MEDICARE: DR. DANIEL R MARSHALL DO

MEDICARE: DR. DANIEL R MARSHALL DO
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
1207P00000XEmergency Medicine Physician2006018423MO
2207ND0101XMOHS-Micrographic Surgery PhysicianO-0508ID
3207N00000XDermatology PhysicianO-0508ID

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 : 1861583486
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. DANIEL R MARSHALL DO
Provider Business Mailing Address
First Line : 393 E 2ND N
Second Line :
City : REXBURG
State : ID
Zip : 83440-1605
Country : US
Telephone Number : 208-359-4841
Fax Number : 208-359-4842
Provider Business Practice Location Address
First Line : 393 E 2ND N
Second Line :
City : REXBURG
State : ID
Zip : 83440-1605
Country : US
Telephone Number : 208-359-4841
Fax Number : 208-359-4842
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/27/2006
Last Update Date : 09/29/2020

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