Healthcare Provider Details

I. General information

NPI: 1659351237
Provider Name (Legal Business Name): DAVID MARTIN JOSEPH M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 01/19/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3390 N CAMPBELL AVE SUITE 110
TUCSON AZ
85719-2380
US

IV. Provider business mailing address

2260 ISLAND COVE CIR
NAPLES FL
34109-0341
US

V. Phone/Fax

Practice location:
  • Phone: 520-795-7605
  • Fax:
Mailing address:
  • Phone: 239-592-5360
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code209800000X
TaxonomyLegal Medicine (M.D./D.O.) Physician
License Number18703
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: