Provider Demographics
NPI:1104992627
Name:MARSHALL, WILLIAM JEFFERY (MD)
Entity type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:JEFFERY
Last Name:MARSHALL
Suffix:
Gender:M
Credentials:MD
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Other - Middle Name:
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Mailing Address - Street 1:2255 LEWISVILLE CLEMMONS RD STE E
Mailing Address - Street 2:
Mailing Address - City:CLEMMONS
Mailing Address - State:NC
Mailing Address - Zip Code:27012-7460
Mailing Address - Country:US
Mailing Address - Phone:336-766-0505
Mailing Address - Fax:336-766-8586
Practice Address - Street 1:2255 LEWISVILLE CLEMMONS RD STE E
Practice Address - Street 2:
Practice Address - City:CLEMMONS
Practice Address - State:NC
Practice Address - Zip Code:27012-7460
Practice Address - Country:US
Practice Address - Phone:336-766-0505
Practice Address - Fax:336-766-0553
Is Sole Proprietor?:No
Enumeration Date:2006-11-27
Last Update Date:2025-11-06
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NC285392084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC8954028Medicaid
NC8954028Medicaid
NCC82226Medicare UPIN