Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 2080N0001X | Neonatal-Perinatal Doctor | 10202A | WY |
Y | 2080N0001X | Neonatal-Perinatal Doctor | 2204 | OK |
NPI | 1134186737 |
---|---|
Provider Name | James Richard Marshall |
First Address | Lawton, OK 73502-2309 |
Second Address | Lawton, OK 73505-6328 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 27/04/2006 |
Last Update Date | 21/07/2017 |