Marshall, Dennis N

Marshall, Dennis N is an sole proprietor health care provider with primary practice located at 1495 Parkway Dr Ste A , Blackfoot ID 83221-1639. He recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as his primary health care specialty. Marshall, Dennis N can be contacted via phone (208) 785-3063.

Contact Information

Primary practice address
1495 Parkway Dr Ste A Blackfoot ID 83221-1639
Fax: (208) 782-1392
Website:

Health care specialties

SpecialtyCodeLicense #State
Eye and Vision Services Providers / Optometrist 152W00000X ODP-652 Idaho

Profile Details

NPI number 1477548220
LBN Legal business name Marshall, Dennis N
Credentials O.D., P.A.
Entity Individual
Sole proprietor 1 Yes
Enumeration date Sep 19th, 2005
Last updated Feb 25th, 2013 - about 12 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1477548220 NPPES
Idaho MEDICAID 001261500

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