Healthcare Provider Details

I. General information

NPI: 1790315810
Provider Name (Legal Business Name): CHRISTOPHER ALAN MARTIN PHARMD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/16/2020
Last Update Date: 05/11/2026
Certification Date: 05/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5928 ZEBULON RD
MACON GA
31210-2097
US

IV. Provider business mailing address

5928 ZEBULON RD
MACON GA
31210-2097
US

V. Phone/Fax

Practice location:
  • Phone: 478-757-4152
  • Fax: 478-757-9132
Mailing address:
  • Phone: 478-757-4152
  • Fax: 478-757-9132

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835P0018X
TaxonomyPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
License Number019621
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: