Provider Demographics
NPI:1942740329
Name:MARSHALL, JEFFREY T (DO)
Entity Type:Individual
Prefix:
First Name:JEFFREY
Middle Name:T
Last Name:MARSHALL
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:444 N CLEVELAND AVE STE 200
Mailing Address - Street 2:
Mailing Address - City:WESTERVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43082-8389
Mailing Address - Country:US
Mailing Address - Phone:614-899-2700
Mailing Address - Fax:614-823-5656
Practice Address - Street 1:444 N CLEVELAND AVE STE 200
Practice Address - Street 2:
Practice Address - City:WESTERVILLE
Practice Address - State:OH
Practice Address - Zip Code:43082-8389
Practice Address - Country:US
Practice Address - Phone:614-899-2700
Practice Address - Fax:614-823-5656
Is Sole Proprietor?:No
Enumeration Date:2017-03-03
Last Update Date:2020-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH34.014595207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine