Provider Demographics
NPI:1043360662
Name:MARSHALL INTERNAL MEDICINE ASSOCIATES
Entity Type:Organization
Organization Name:MARSHALL INTERNAL MEDICINE ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:DOROTHY
Authorized Official - Middle Name:A
Authorized Official - Last Name:FLARITY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:903-927-6803
Mailing Address - Street 1:815 S WASHINGTON AVE
Mailing Address - Street 2:SUITE 100
Mailing Address - City:MARSHALL
Mailing Address - State:TX
Mailing Address - Zip Code:75670-5369
Mailing Address - Country:US
Mailing Address - Phone:903-927-6800
Mailing Address - Fax:
Practice Address - Street 1:815 S WASHINGTON AVE
Practice Address - Street 2:SUITE 100
Practice Address - City:MARSHALL
Practice Address - State:TX
Practice Address - Zip Code:75670-5369
Practice Address - Country:US
Practice Address - Phone:903-927-6800
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-12
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical Specialty