Provider Demographics
NPI:1023767902
Name:MARSHALL FAMILY MEDICINE LLC
Entity type:Organization
Organization Name:MARSHALL FAMILY MEDICINE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:THUY LAN
Authorized Official - Middle Name:THI
Authorized Official - Last Name:OLSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:540-364-8199
Mailing Address - Street 1:4197C WINCHESTER RD
Mailing Address - Street 2:
Mailing Address - City:MARSHALL
Mailing Address - State:VA
Mailing Address - Zip Code:20115-3252
Mailing Address - Country:US
Mailing Address - Phone:540-364-8199
Mailing Address - Fax:540-360-9889
Practice Address - Street 1:4197 WINCHESTER RD
Practice Address - Street 2:
Practice Address - City:MARSHALL
Practice Address - State:VA
Practice Address - Zip Code:20115-3252
Practice Address - Country:US
Practice Address - Phone:703-657-9612
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-03-20
Last Update Date:2022-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty