Provider Demographics
NPI:1174547988
Name:MARSH, MICHAEL A (MD)
Entity type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:A
Last Name:MARSH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:7805 PHOENIX AVE
Mailing Address - Street 2:
Mailing Address - City:FORT SMITH
Mailing Address - State:AR
Mailing Address - Zip Code:72903
Mailing Address - Country:US
Mailing Address - Phone:479-242-4220
Mailing Address - Fax:479-242-4221
Practice Address - Street 1:7805 PHOENIX AVE
Practice Address - Street 2:
Practice Address - City:FORT SMITH
Practice Address - State:AR
Practice Address - Zip Code:72903-5091
Practice Address - Country:US
Practice Address - Phone:479-242-4220
Practice Address - Fax:479-242-4221
Is Sole Proprietor?:No
Enumeration Date:2006-07-26
Last Update Date:2022-07-05
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
ARC8388207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK100032240AMedicaid
AR122738001Medicaid
OK100032240AMedicaid
AR122738001Medicaid