Doctor Name: | DR. CLIFFORD B MARSTON |
NPI Number: | 1053304303 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | DPM |
License Number: | 000477 |
Business Practice Address: | 400 S College St Mountain Home, AR - 726533923 |
Business Phone Number: | 8704251466 |
Business Fax Number: | 8704257655 |
Mailing Address: | 400 S College St, MOUNTAIN HOME |
State: | AR |
Postal Code: | 726533991 |
Phone Number: | 8704251466 |
Fax Number: | 8704257655 |
NPI Enumeration Date: | 08/23/2005 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | 03/27/2006 |
NPI Reactivation Date: | 04/03/2006 |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 213ES0103X |
License Number: | 000477 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | MO |
Taxonomy Type: | Podiatric Medicine & Surgery Service Providers |
Taxonomy Classification: | Podiatrist |
Taxonomy Specialization: | Foot & Ankle Surgery |
Taxonomy Definition: |