| Dr Jack E Marshall, MD | |
|
14100 Parkway Commons Dr Ste 102, Oklahoma City, OK 73134-6036 | |
| (406) 286-9820 | |
| (405) 286-9813 |
| Full Name | Dr Jack E Marshall |
|---|---|
| Gender | Male |
| Speciality | Pain Medicine - Interventional Pain Medicine |
| Location | 14100 Parkway Commons Dr Ste 102, Oklahoma City, Oklahoma |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1982608873 | NPI | - | NPPES |
| 050058014 | Other | OK | OLD MEDICARE RR |
| 100124480A | Medicaid | OK | |
| P00445607 | Other | OK | MEDICARE RR |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207L00000X | Anesthesiology | 15252 (Oklahoma) | Secondary |
| 208VP0014X | Pain Medicine - Interventional Pain Medicine | 15252 (Oklahoma) | Primary |
| Entity Name | Jack E. Marshall M.d. Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1568701332 PECOS PAC ID: 6901044346 Enrollment ID: O20130524000470 |
| Mailing Address | Practice Location Address |
|---|---|
| Dr Jack E Marshall, MD Po Box 269031, Oklahoma City, OK 73126-9031 Ph: (405) 286-9820 | Dr Jack E Marshall, MD 14100 Parkway Commons Dr Ste 102, Oklahoma City, OK 73134-6036 Ph: (406) 286-9820 |
Cheng-lun Soo, MD Pain Medicine Medicare: Accepting Medicare Assignments Practice Location: 13700 S Western Ave Ste 100, Oklahoma City, OK 73170 Phone: 405-631-4263 Fax: 405-982-1583 | |
Arthur Douglas Beacham Iii, D.O. Pain Medicine Medicare: Accepting Medicare Assignments Practice Location: 9800 Broadway Ext Ste 203, Oklahoma City, OK 73114 Phone: 405-424-5415 Fax: 405-424-5416 | |
Timothy Luke Cramer, MD Pain Medicine Medicare: Accepting Medicare Assignments Practice Location: 1226 N Shartel Ave, Suite 300, Oklahoma City, OK 73103 Phone: 405-232-8003 Fax: 405-232-8008 | |
Peyton Johnson, D.O. Pain Medicine Medicare: Not Enrolled in Medicare Practice Location: 825 Ne 10th St Ste 2b, Oklahoma City, OK 73104 Phone: 405-271-4351 Fax: 405-271-8796 | |
Dr. Randall Wayne Henthorn, MD Pain Medicine Medicare: Not Enrolled in Medicare Practice Location: 750 Ne 13th St, Oac 200, Oklahoma City, OK 73104 Phone: 405-271-4351 Fax: 405-271-8695 | |
Dr. Avani Sheth, MD Pain Medicine Medicare: Not Enrolled in Medicare Practice Location: 4200 W Memorial Rd, Ste 305, Oklahoma City, OK 73120 Phone: 405-841-7899 Fax: 405-749-9779 | |
Shawn Michael Ellis, DO Pain Medicine Medicare: Accepting Medicare Assignments Practice Location: 4345 W Memorial Rd Ste 110, Oklahoma City, OK 73134 Phone: 405-418-7000 |