Provider Demographics
NPI:1023750742
Name:MARSHALL, JOHN D (RPH)
Entity type:Individual
Prefix:
First Name:JOHN
Middle Name:D
Last Name:MARSHALL
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1331 CLAY ST
Mailing Address - Street 2:
Mailing Address - City:HENDERSON
Mailing Address - State:KY
Mailing Address - Zip Code:42420-4203
Mailing Address - Country:US
Mailing Address - Phone:270-827-3503
Mailing Address - Fax:270-827-4934
Practice Address - Street 1:1331 CLAY ST
Practice Address - Street 2:
Practice Address - City:HENDERSON
Practice Address - State:KY
Practice Address - Zip Code:42420-4203
Practice Address - Country:US
Practice Address - Phone:270-827-3503
Practice Address - Fax:270-827-4934
Is Sole Proprietor?:Yes
Enumeration Date:2022-04-12
Last Update Date:2022-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0002XSuppliersPharmacyClinic Pharmacy