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NPI Code Detail

MEDICARE: DR. REG C MARTIN MD

MEDICARE:  DR. REG C MARTIN  MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1173000000XLegal MedicineL4053TX
2207L00000XAnesthesiology PhysicianL4053TX

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
28F8292OTHERTXBC/BS

General Provider Information

NPI Number : 1336120740
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. REG C MARTIN MD
Provider Business Mailing Address
First Line : 801 S FILLMORE ST
Second Line : SUITE 410
City : AMARILLO
State : TX
Zip : 79101-3537
Country : US
Telephone Number : 806-355-9595
Fax Number : 806-353-1589
Provider Business Practice Location Address
First Line : 1501 S COULTER ST
Second Line :
City : AMARILLO
State : TX
Zip : 79106-1770
Country : US
Telephone Number : 806-354-1000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/11/2005
Last Update Date : 06/29/2010

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Directions to “ DR. REG C MARTIN MD” Practice Location

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