Provider Demographics
NPI:1124186820
Name:ALFARO MARSHALL, ERIKA N (RADIOLOGY TECHNICIAN)
Entity Type:Individual
Prefix:MS
First Name:ERIKA
Middle Name:N
Last Name:ALFARO MARSHALL
Suffix:
Gender:F
Credentials:RADIOLOGY TECHNICIAN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1334 N LANSING
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74106
Mailing Address - Country:US
Mailing Address - Phone:918-587-2171
Mailing Address - Fax:918-295-6149
Practice Address - Street 1:1334 N LANSING
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74106
Practice Address - Country:US
Practice Address - Phone:918-587-2171
Practice Address - Fax:918-295-6149
Is Sole Proprietor?:No
Enumeration Date:2006-12-05
Last Update Date:2007-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK3892422085B0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085B0100XAllopathic & Osteopathic PhysiciansRadiologyBody Imaging
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK37-1832OtherMEDICARE
OK389242OtherLICENSE NUMBER
OK37-1834OtherMEDICARE
OK37-1803OtherMEDICARE