Healthcare Provider Details

I. General information

NPI: 1821690074
Provider Name (Legal Business Name): RACHEL E MARTIN DPM
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/12/2020
Last Update Date: 04/28/2026
Certification Date: 04/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9305 W THOMAS RD STE 225
PHOENIX AZ
85037-3363
US

IV. Provider business mailing address

13632 W HACKAMORE DR
PEORIA AZ
85383-6177
US

V. Phone/Fax

Practice location:
  • Phone: 623-536-9822
  • Fax: 623-536-3448
Mailing address:
  • Phone: 602-510-0952
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License Number41000446A
License Number StateIN
# 2
Primary TaxonomyY
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License NumberPOD-001116
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: