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
Phone: (208) 785-3063
Fax: (208) 782-1392
Website:
Health care specialties
| Specialty | Code | License # | 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1477548220 | NPPES |
| Idaho | MEDICAID | 001261500 |
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