Provider Demographics
NPI:1467485193
Name:MARABLE, SHAWN MICHELLE (OD)
Entity Type:Individual
Prefix:DR
First Name:SHAWN
Middle Name:MICHELLE
Last Name:MARABLE
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
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Mailing Address - Street 1:731 LITTY CT APT 306
Mailing Address - Street 2:
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38103-8784
Mailing Address - Country:US
Mailing Address - Phone:512-635-6796
Mailing Address - Fax:
Practice Address - Street 1:2200 FORT ROOTS DR BLDG 66-EYE
Practice Address - Street 2:
Practice Address - City:NORTH LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72114-1709
Practice Address - Country:US
Practice Address - Phone:501-257-2276
Practice Address - Fax:501-257-2022
Is Sole Proprietor?:No
Enumeration Date:2006-07-08
Last Update Date:2020-09-11
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TX5515TG152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist