MEDICARE: DR. RAY MARK MARTIN M.D.

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
1	207Q00000X	Family Medicine Physician	F4248	TX

General Provider Information

NPI Number	:	1831197300
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. RAY MARK MARTIN M.D.

Provider Business Mailing Address
First Line	:	2506 CROCKETT DR
Second Line	:
City	:	BROWNWOOD
State	:	TX
Zip	:	76801-5900
Country	:	US
Telephone Number	:	325-643-3656
Fax Number	:	325-646-8484

Provider Business Practice Location Address
First Line	:	2506 CROCKETT DR
Second Line	:
City	:	BROWNWOOD
State	:	TX
Zip	:	76801-5900
Country	:	US
Telephone Number	:	325-643-3656
Fax Number	:	325-646-8484

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/08/2005
Last Update Date	:	01/29/2008

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Directions to “ DR. RAY MARK MARTIN M.D.” Practice Location

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