Healthcare Provider Details

I. General information

NPI: 1033043799
Provider Name (Legal Business Name): JOSHUA ASHTON MARTIN
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/09/2026
Last Update Date: 06/09/2026
Certification Date: 06/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 VESTAVIA PKWY
VESTAVIA AL
35216-7715
US

IV. Provider business mailing address

100 VANCOUVER CT
BIRMINGHAM AL
35211-6927
US

V. Phone/Fax

Practice location:
  • Phone: 205-490-5364
  • Fax:
Mailing address:
  • Phone: 205-936-8462
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: