Provider Demographics
NPI:1528025475
Name:MARSHALL, SAMUEL IAN (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:SAMUEL
Middle Name:IAN
Last Name:MARSHALL
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:639 LEGACY PARK AVE
Mailing Address - Street 2:
Mailing Address - City:CEDAR CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84720-1870
Mailing Address - Country:US
Mailing Address - Phone:435-586-8293
Mailing Address - Fax:
Practice Address - Street 1:95 E CENTER ST
Practice Address - Street 2:
Practice Address - City:PANGUITCH
Practice Address - State:UT
Practice Address - Zip Code:84759-7703
Practice Address - Country:US
Practice Address - Phone:435-676-2212
Practice Address - Fax:435-676-8850
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-26
Last Update Date:2022-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT341398-1701183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist