DR. JACOB C. MARSHALL JR. (NPI# 1922081249) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1922081249 |
| Entity Type | Individual |
| Full Name | DR. JACOB C. MARSHALL JR. |
| Credential | M.D. |
| Practice Address |
103 N Oak St O Fallon IL 62269-1165 |
| Mailing Address |
2200 Bowler Rd Collinsville IL 62234-7012 |
| Practice Telephone | 8885776337 |
| Mailing Telephone | 6189779607 |
| Mailing Fax Number | 6186249302 |
| Enumeration Date | 2005-11-21 |
| Last Update Date | 2010-07-12 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207P00000X | Emergency Medicine | 036-102192 | IL | Allopathic & Osteopathic Physicians |
| Y | 207Q00000X | Family Medicine | 036102192 | IL | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IL | 036102192-9 | 05 | |
| IL | 036102192 -8 | 05 | |
| MO | 1922081249 | 05 | |
| IL | 036102192 | 05 | |
| IL | BLUE CROSS BLUE SHIELD | 08232204 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689948952 | Jacob Marshall | Chiropractor | 7807 Baymeadows Rd E Ste 201, Jacksonville, FL 32256-9666 | 2012-03-03 |
| 1629505623 | Jacob Morel Marshall | Student in an Organized Health Care Education/Training Program | Navy Hospital Camp Pendleton, 200 Mercy Circle Box 555191, Camp Pendleton, CA 92055 | 2017-05-22 |
| Street Address |
103 N OAK ST |
| City | O FALLON |
| State | IL |
| Zip Code | 62269-1165 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952592586 | Kathryn J Clayton | Emergency Medicine | 103 N Oak St, O Fallon, IL 62269-1165 | 2007-08-08 |
| 1477679991 | Victor Sun | Emergency Medicine | 103 N Oak St, O Fallon, IL 62269-1165 | 2007-03-22 |
| 1073609814 | Maria Galanos | Emergency Medicine | 103 N Oak St, O Fallon, IL 62269-1165 | 2006-10-05 |
| 1306931159 | Donna Boone | Emergency Medicine | 103 N Oak St, O Fallon, IL 62269-1165 | 2006-10-04 |
| 1841385531 | Kevin Corrigan | Emergency Medicine | 103 N Oak St, O Fallon, IL 62269-1165 | 2006-10-04 |
| 1063503704 | Kelly Farroll | Emergency Medicine | 103 N Oak St, O Fallon, IL 62269-1165 | 2006-09-27 |
| 1225129968 | Brian Litland | Emergency Medicine | 103 N Oak St, O Fallon, IL 62269-1165 | 2006-09-27 |
| 1639275977 | Gregory G Lawson | Emergency Medicine | 103 N Oak St, O Fallon, IL 62269-1165 | 2006-09-15 |
| 1548365729 | Salvador Chavez | Emergency Medicine | 103 N Oak St, O Fallon, IL 62269-1165 | 2006-09-13 |
| 1023042165 | Arthur Sippo | Emergency Medicine | 103 N Oak St, O Fallon, IL 62269-1165 | 2006-07-11 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326648155 | Kayla Revermann | Pharmacist | 1350 W Us Highway 50, Pharmacy, O Fallon, IL 62269 | 2020-10-30 |
| 1942814272 | Ashley Monique Gibson | Behavior Technician | Eagle Center, Ste 10, Ofallon, IL 62269 | 2020-09-03 |
| 1013533819 | Michelle Denise Voudrie | Registered Nurse | 321 Regency Park, O'fallon, IL 62269 | 2020-06-18 |
| 1598398455 | Washington University Physicians In Illinois - Cancer Center Pharmacy | Pharmacy | 1418 Cross Street, Suite 180, Shiloh, IL 62269 | 2020-02-19 |
| 1962063800 | Gerald Paskert | Pharmacist | 122 W. State St., O'fallon, IL 62269 | 2019-06-21 |
| 1780144808 | Bonnie Jean Lampe | Physical Therapy Assistant | 316 Donna Dr, O'fallon, IL 62269 | 2019-03-24 |
| 1134633993 | Latisha Smith | Psychologist | 600 S. Smiley St., O'fallon, IL 62269 | 2017-11-30 |
| 1619407210 | Brenna M Thomas | Registered Nurse | 1310 Engle Ct, O'fallon, IL 62269 | 2017-06-15 |
| 1881135622 | Pc Associates, LLC | Family Medicine | 800 East Highway 50, O'fallon, IL 62269 | 2017-03-13 |
| 1700230539 | Jennifer Farrell | Family Medicine | 3 St. Elizabeth's Blvd, Ste. 4000, O'fallon, IL 62269 | 2016-04-18 |
| Find all providers in zip 62269 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477019909 | Family Medical Clinic Pllc | Family Medicine | 1480 N Green Mount Rd Suite 200, O Fallon, IL 62269-3466 | 2019-02-20 |
| 1700351822 | Justin Andrew Steinkamp | Family Medicine | 1002 Peruque Crossing Ct Ste 101, O Fallon, MO 63366-2381 | 2018-10-04 |
| 1912345935 | Jackson Charles Pugh | Family Medicine | 300 Winding Woods Dr Ste 100, O Fallon, MO 63366-5080 | 2013-06-12 |
| 1518228170 | Jaime Rebecca Obszanski | Family Medicine | 1414 Cross St Ste 210, O Fallon, IL 62269 | 2012-05-30 |
| 1427345263 | Alison Juliete Ball | Family Medicine | 2223 Technology Dr, Suite 40, O Fallon, MO 63368-7272 | 2011-06-30 |
| 1083824684 | Amy Elizabeth Grawey | Family Medicine | 207 E Pitman St, O Fallon, MO 63366-2620 | 2007-05-23 |
| 1104991017 | Rema Sanghavi | Family Medicine | 1512 N Green Mount Rd Ste 108, O Fallon, IL 62269 | 2006-11-24 |
| 1316025554 | Robert F Holloway | Family Medicine | 935 Green Briar Hills Dr, O Fallon, MO 63366-5596 | 2006-11-02 |
| 1245287085 | James Robert Lundy | Family Medicine | 320 E Highway 50, O Fallon, IL 62269-2704 | 2006-05-27 |
| 1083689061 | John J. O'brien | Family Medicine | 2630 Highway K, O Fallon, MO 63368-6624 | 2006-02-22 |
| Find all providers in O FALLON | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.