Provider Demographics
NPI:1598848665
Name:ROBERT J MARSHALL
Entity Type:Organization
Organization Name:ROBERT J MARSHALL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:J
Authorized Official - Last Name:MARSHALL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:509-946-0400
Mailing Address - Street 1:925 STEVENS DR
Mailing Address - Street 2:SUITE 3-C
Mailing Address - City:RICHLAND
Mailing Address - State:WA
Mailing Address - Zip Code:99352-3523
Mailing Address - Country:US
Mailing Address - Phone:509-946-0400
Mailing Address - Fax:509-946-1685
Practice Address - Street 1:925 STEVENS DR
Practice Address - Street 2:SUITE 3-C
Practice Address - City:RICHLAND
Practice Address - State:WA
Practice Address - Zip Code:99352-3523
Practice Address - Country:US
Practice Address - Phone:509-946-0400
Practice Address - Fax:509-946-1685
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-23
Last Update Date:2020-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207NS0135XAllopathic & Osteopathic PhysiciansDermatologyProcedural DermatologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA=========OtherTAX ID