Provider Demographics
NPI:1558553594
Name:MARSHALL INPATIENT PHYSICIAN
Entity Type:Organization
Organization Name:MARSHALL INPATIENT PHYSICIAN
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MD/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:M
Authorized Official - Last Name:SAYLOR
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:256-505-6826
Mailing Address - Street 1:PO BOX 150
Mailing Address - Street 2:
Mailing Address - City:UNION GROVE
Mailing Address - State:AL
Mailing Address - Zip Code:35175-0150
Mailing Address - Country:US
Mailing Address - Phone:256-505-6826
Mailing Address - Fax:256-571-2862
Practice Address - Street 1:3120 NORTH ST
Practice Address - Street 2:
Practice Address - City:GUNTERSVILLE
Practice Address - State:AL
Practice Address - Zip Code:35976-2912
Practice Address - Country:US
Practice Address - Phone:256-582-6561
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-14
Last Update Date:2020-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL22856207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL009933006Medicaid
AL1174589410OtherINDIVIDUAL NPI
ALK643OtherMEDICARE LEGACY NUMBER
AL=========OtherTAX ID #