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Individual

DR. MARSHALL JOHN BALES

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
1300 SOUTH DRIVE, WINNEBAGO, WI 54985-0009
(920) 235-4910
(920) 237-2043
Mailing address
601 HOUGHTELING ST, IRON MOUNTAIN, MI 49801-6828
(906) 396-5075

Taxonomy

Speciality
Code
Description
License number
State
2084F0202X
Forensic Psychiatry Physician
Primary
31871
WI
2084P0800X
Psychiatry Physician
04-23919
KS

Other

Enumeration date
06/12/2006
Last updated
04/07/2017
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