Provider Demographics
NPI:1740302041
Name:MARSHALL, JAMES WILLIAM (RPH)
Entity type:Individual
Prefix:
First Name:JAMES
Middle Name:WILLIAM
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 1:103 MOON AVE
Mailing Address - Street 2:
Mailing Address - City:LEITCHFIELD
Mailing Address - State:KY
Mailing Address - Zip Code:42754-1405
Mailing Address - Country:US
Mailing Address - Phone:270-259-5980
Mailing Address - Fax:
Practice Address - Street 1:201 MILLERSTOWN ST.
Practice Address - Street 2:
Practice Address - City:CLARKSON
Practice Address - State:KY
Practice Address - Zip Code:42726-0146
Practice Address - Country:US
Practice Address - Phone:270-242-3811
Practice Address - Fax:270-242-4171
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY008554183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist