Individual
DON A MARSHALL JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3010 E STATE BLVD, SUTIE 100, FORT WAYNE, IN 46805-4700
(260) 471-0632
(260) 471-3451
Mailing address
3010 E STATE BLVD, SUTIE 100, FORT WAYNE, IN 46805-4700
(260) 471-0632
(260) 471-3451
Taxonomy
Speciality
Code
Description
License number
State
2084A0401X
Addiction Medicine (Psychiatry & Neurology) Physician
01038606A
IN
2084P0800X
Psychiatry Physician
Primary
01038606A
IN
2084P0802X
Addiction Psychiatry Physician
01038606A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000006472
MPLAN & 3 RIVERS
IN
01
—
000000093110
ANTHEM BCBS
IN
01
—
01008583
HEALTHPLUS
IN
01
—
01652800
MEGELLAN
IN
01
—
063909
VALUE OPT
IN
05
—
0944554
—
OH
05
—
100082250B
—
IN
01
—
10082250B
PCCM
IN
01
—
119094
COMPSYCH
IN
01
—
3382
PHP
IN
01
—
93110
ANTHEM HIP
IN
Enumeration date
05/22/2006
Last updated
08/03/2015
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