Provider Demographics
NPI:1134186737
Name:MARSHALL, JAMES RICHARD (DO)
Entity type:Individual
Prefix:
First Name:JAMES
Middle Name:RICHARD
Last Name:MARSHALL
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 2309
Mailing Address - Street 2:SECTION 2
Mailing Address - City:LAWTON
Mailing Address - State:OK
Mailing Address - Zip Code:73502-2309
Mailing Address - Country:US
Mailing Address - Phone:580-355-5242
Mailing Address - Fax:580-355-5245
Practice Address - Street 1:3811 W GORE BLVD
Practice Address - Street 2:STE 6
Practice Address - City:LAWTON
Practice Address - State:OK
Practice Address - Zip Code:73505-6328
Practice Address - Country:US
Practice Address - Phone:580-355-5242
Practice Address - Fax:580-355-5245
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-27
Last Update Date:2017-07-21
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
WY10202A2080N0001X
OK22042080N0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080N0001XAllopathic & Osteopathic PhysiciansPediatricsNeonatal-Perinatal Medicine