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DEMETRI W MARSHALL M.D.

>> Family Medicine >> Allopathic & Osteopathic Physicians

Registrant NPI Number: 1740385103

Individual Registrant:
 DEMETRI W MARSHALL M.D.
Gender: M
Not Sole Proprietor

Location and contact information for practice:
2045 HIGHWAY 61 NORTH  PORT GIBSON, MS 39150-4262 US
Tel: 601-437-3050  Fax: 601-437-3051

Contact information for business:
P. O. BOX 741  PORT GIBSON, MS 39150-4262 US
Tel: 601-437-3050  Fax: 601-437-3051

Registration Information:
NPI: 1740385103
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y207Q00000XAllopathic & Osteopathic Physicians
Family Medicine
MS10558

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType
0017759MS05




HEALTH CARE JOBS MS - Page 1



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