Individual
DR. DANIEL R MARSHALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
393 E 2ND N, REXBURG, ID 83440-1605
(208) 359-4841
(208) 359-4842
Mailing address
393 E 2ND N, REXBURG, ID 83440-1605
(208) 359-4841
(208) 359-4842
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
O-0508
ID
207ND0101X
MOHS-Micrographic Surgery Physician
Primary
O-0508
ID
207P00000X
Emergency Medicine Physician
2006018423
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
808295400
—
ID
Enumeration date
09/27/2006
Last updated
09/29/2020
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