Marshall, Jack E
Marshall, Jack E is an individual health care provider with primary practice located at 14100 Parkway Commons Dr Ste 102 , Oklahoma City OK 73134-6036. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Anesthesiology, Allopathic & Osteopathic Physicians / Interventional Pain Medicine. Allopathic & Osteopathic Physicians / Interventional Pain Medicine is his primary health care specialty. Marshall, Jack E can be contacted via phone (406) 286-9820.Contact Information
Primary practice address
14100 Parkway Commons Dr Ste 102
Oklahoma City OK 73134-6036
Phone: (406) 286-9820
Fax: (405) 286-9813
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Anesthesiology | 207L00000X | 15252 | Oklahoma |
| Allopathic & Osteopathic Physicians / Interventional Pain Medicine | 208VP0014X | 15252 | Oklahoma |
Profile Details
| NPI number | 1982608873 |
|---|---|
| LBN Legal business name | Marshall, Jack E |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jun 8th, 2005 |
| Last updated | Feb 20th, 2020 - about 4 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1982608873 | NPPES |
| Oklahoma | Other | 050058014 | OLD MEDICARE RR |
| Oklahoma | MEDICAID | 100124480A | OLD MEDICARE RR |
| Oklahoma | Other | P00445607 | OLD MEDICARE RR |
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