Male or Other

Dr. Jack E. Marshall MD

Interventional Pain Medicine Physician in Oklahoma City, OK(View on Map)

Full Name

Dr. Jack E Marshall MD

NPI Number

1982608873

NPI Type

Individual Provider

Gender

Male

Enumeration Date

06/08/2005

Specialties

(Taxonomies)

Code

208VP0014X
207L00000X

Primary Taxonomy

Yes
No

Licenses

State

Oklahoma

License Number

15252

Contact
Information

Purpose

Mailing
Location

Address

PO BOX 269031
14100 PARKWAY COMMONS DR STE 102

City

Oklahoma City
Oklahoma City

State

OK
OK

Postal Code

73126-9031
73134-6036

Country

US
US

Telephone Number

(405) 286-9820
(406) 286-9820

Identifiers

Identifier

050058014
100124480A
P00445607

Identifier State

OK
OK
OK

Identifier Issuer

OLD MEDICARE RR
Unknown
MEDICARE RR

Provider data last refreshed from NPPES NPI registry on 11/19/2024

Data last updated by provider on 02/20/2020

Provider Address

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