Provider Demographics
NPI:1336330976
Name:JOHN D MARSHALL MD INC
Entity Type:Organization
Organization Name:JOHN D MARSHALL MD INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:INS. BILLER
Authorized Official - Prefix:MRS
Authorized Official - First Name:LINDA
Authorized Official - Middle Name:EVON
Authorized Official - Last Name:WRIGHT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:229-931-0446
Mailing Address - Street 1:905 N JACKSON ST STE B
Mailing Address - Street 2:
Mailing Address - City:AMERICUS
Mailing Address - State:GA
Mailing Address - Zip Code:31719-3089
Mailing Address - Country:US
Mailing Address - Phone:229-931-0446
Mailing Address - Fax:229-924-6373
Practice Address - Street 1:905 N JACKSON ST STE B
Practice Address - Street 2:
Practice Address - City:AMERICUS
Practice Address - State:GA
Practice Address - Zip Code:31719-3089
Practice Address - Country:US
Practice Address - Phone:229-931-0446
Practice Address - Fax:229-924-6373
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-08
Last Update Date:2014-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA1336330976OtherGROUP NPI
GAGRP4909OtherMEDICARE GROUP NUMBER