Jacob C. Marshall, M.D. Valid NPI

Individual provider · Family Medicine Physician · O Fallon, IL

NPI

1922081249

Type

Individual (Type 1)

Primary specialty

Family Medicine Physician (Family Medicine)

Specialty group

Allopathic & Osteopathic Physicians

Taxonomy code

207Q00000X

License number

036102192 (IL)

Sex

Male

Sole proprietor

Yes

Enumerated

2005-11-21

Last updated

2010-07-12