Individual
DR. JON BARRY MARSHALL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
450 E PASS RD STE 9, GULFPORT, MS 39507-3212
(228) 896-8619
(228) 896-8619
Mailing address
450 E PASS RD STE 9, GULFPORT, MS 39507-3212
(228) 896-8619
(228) 896-8619
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
482
MS
332B00000X
Durable Medical Equipment & Medical Supplies
482
MS
332H00000X
Eyewear Supplier
482
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00087901
—
MS
Enumeration date
01/27/2007
Last updated
05/28/2008
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