Individual
TARA L MARSHALL
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
2021 N 12TH ST, COMMUNITY HOSPITAL, GRAND JUNCTION, CO 81501
(970) 256-6463
(970) 256-6512
Mailing address
PO BOX 4235, GRAND JUNCTION, CO 81502
(970) 256-6463
(970) 256-6512
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
40612
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
35573864
—
CO
01
—
P00171104
RAILROAD MEDICARE
—
05
—
T0158
—
UT
Enumeration date
11/10/2005
Last updated
07/08/2007
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