Provider Demographics
NPI:1275795528
Name:MARSH, JONATHAN WALTON (MD)
Entity Type:Individual
Prefix:DR
First Name:JONATHAN
Middle Name:WALTON
Last Name:MARSH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2338 IMMOKALEE RD
Mailing Address - Street 2:SUITE 186
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34110-1445
Mailing Address - Country:US
Mailing Address - Phone:239-330-2933
Mailing Address - Fax:
Practice Address - Street 1:2338 IMMOKALEE RD
Practice Address - Street 2:SUITE 186
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34110-1445
Practice Address - Country:US
Practice Address - Phone:239-330-2933
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-27
Last Update Date:2017-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SCMD30910207R00000X
FLME113346207R00000X, 208M00000X
SCLL 30910207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalist
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine