Provider Demographics
NPI:1942607049
Name:MARSHALL, SPENCER STEELE (PHARMD)
Entity Type:Individual
Prefix:
First Name:SPENCER
Middle Name:STEELE
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 1:6255 E GRANT RD
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85712-5804
Mailing Address - Country:US
Mailing Address - Phone:520-298-7994
Mailing Address - Fax:
Practice Address - Street 1:6255 E GRANT RD
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85712-5804
Practice Address - Country:US
Practice Address - Phone:520-298-7994
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-12-04
Last Update Date:2014-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZS021039183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist