Provider Demographics
NPI:1285297549
Name:HARRIS, MARSHALL DAVID (DO)
Entity type:Individual
Prefix:DR
First Name:MARSHALL
Middle Name:DAVID
Last Name:HARRIS
Suffix:
Gender:M
Credentials:DO
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Mailing Address - Street 1:3148 WOODWARD BLVD
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74105-2038
Mailing Address - Country:US
Mailing Address - Phone:248-875-9472
Mailing Address - Fax:
Practice Address - Street 1:DEPARTMENT OF RADIOLOGY 3901 RAINBOW BLVD MS 4032
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:KS
Practice Address - Zip Code:66160-9020
Practice Address - Country:US
Practice Address - Phone:913-588-1847
Practice Address - Fax:913-945-5062
Is Sole Proprietor?:No
Enumeration Date:2019-04-22
Last Update Date:2024-07-01
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
KS94117112085N0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085N0700XAllopathic & Osteopathic PhysiciansRadiologyNeuroradiology