Provider Demographics
NPI:1801408224
Name:MARSHALL, JATORIA D (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:JATORIA
Middle Name:D
Last Name:MARSHALL
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6395 AIRPORT BLVD STE A
Mailing Address - Street 2:
Mailing Address - City:MOBILE
Mailing Address - State:AL
Mailing Address - Zip Code:36608-3131
Mailing Address - Country:US
Mailing Address - Phone:251-288-6077
Mailing Address - Fax:
Practice Address - Street 1:6395 AIRPORT BLVD STE A
Practice Address - Street 2:
Practice Address - City:MOBILE
Practice Address - State:AL
Practice Address - Zip Code:36608-3131
Practice Address - Country:US
Practice Address - Phone:251-288-6077
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-08-18
Last Update Date:2020-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL21178183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist