Provider Demographics
NPI:1659343705
Name:MARSHALL, THOMAS JAMES JR (MD)
Entity Type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:JAMES
Last Name:MARSHALL
Suffix:JR
Gender:M
Credentials:MD
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Mailing Address - Street 1:1215 NEWCASTLE CT
Mailing Address - Street 2:
Mailing Address - City:CHULA VISTA
Mailing Address - State:CA
Mailing Address - Zip Code:91913-1452
Mailing Address - Country:US
Mailing Address - Phone:619-482-4834
Mailing Address - Fax:619-532-7673
Practice Address - Street 1:34800 BOB WILSON DR
Practice Address - Street 2:DEPARTMENT OF SURGERY-NAVAL MEDICAL CENTER SAN DIEGO
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92134-3400
Practice Address - Country:US
Practice Address - Phone:619-532-7577
Practice Address - Fax:619-532-7673
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-02-03
Last Update Date:2007-07-08
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Provider Licenses
StateLicense IDTaxonomies
TXH4994208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXF26287Medicare UPIN