Active NPI
William R Marshall MD PA
- Sports Medicine (Orthopaedic Surgery) Physician
- Fort Walton Beach, FL
National Provider Identifier
1396887204
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Sports Medicine (Orthopaedic Surgery) Physician
- License
- ME35510
- Legal business name
- WILLIAM R MARSHALL MD PA
- Practice address
- 1034 Mar Walt Dr Ste 100
Fort Walton Beach, FL 32547-6645 - Phone
- (850) 863-2153
- Fax
- (850) 315-9350
- NPI assigned
- Feb 14, 2007
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Dr. William R Marshall, MD PA
- Title
- Physician
- Phone
- (850) 863-2153
Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Sports Medicine (Orthopaedic Surgery) Physician | 207XX0005X | ME35510 | FL | Primary |
Addresses
Primary practice location
1034 Mar Walt Dr Ste 100
Fort Walton Beach, FL 32547-6645
Mailing address
1034 Mar Walt Dr Ste 100
Fort Walton Beach, FL 32547-6645
Phone (850) 863-2153
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 406203902 | Other | FL | RR MEDICARE |
| DE9184 | Other | FL | RR MEDICARE GROUP |
National Provider Directory
National Provider DirectoryPractitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Orthopaedic Surgery Physician
- Fort Walton Beach, FL
- NPI 1033114426
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1171411200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1212105600000",
"number": "1396887204",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1034 MAR WALT DR STE 100",
"city": "FORT WALTON BEACH",
"state": "FL",
"postal_code": "325476645",
"telephone_number": "850-863-2153",
"fax_number": "850-315-9350"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1034 MAR WALT DR STE 100",
"city": "FORT WALTON BEACH",
"state": "FL",
"postal_code": "325476645",
"telephone_number": "850-863-2153",
"fax_number": "850-315-9350"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "WILLIAM R MARSHALL MD PA",
"organizational_subpart": "NO",
"enumeration_date": "2007-02-14",
"last_updated": "2008-05-30",
"status": "A",
"authorized_official_last_name": "MARSHALL",
"authorized_official_first_name": "WILLIAM",
"authorized_official_middle_name": "R",
"authorized_official_title_or_position": "PHYSICIAN",
"authorized_official_telephone_number": "850-863-2153",
"authorized_official_name_prefix": "Dr.",
"authorized_official_credential": "MD PA"
},
"taxonomies": [
{
"code": "207XX0005X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Orthopaedic Surgery, Sports Medicine",
"state": "FL",
"license": "ME35510",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RR MEDICARE",
"identifier": "406203902",
"state": "FL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RR MEDICARE GROUP",
"identifier": "DE9184",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Fort Walton Beach, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 30, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.