Healthcare Provider Details

I. General information

NPI: 1902806979
Provider Name (Legal Business Name): JOSEPH A MARTIN M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/29/2005
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

235 CANTRELL AVE C/O ROCKINGHAM MEMORIAL HOSPITAL
HARRISONBURG VA
22801-3248
US

IV. Provider business mailing address

240 CLAREMONT AVE
HARRISONBURG VA
22801-2339
US

V. Phone/Fax

Practice location:
  • Phone: 540-422-4100
  • Fax:
Mailing address:
  • Phone: 540-434-5404
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number15076
License Number StateWV
# 2
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number0101239469
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: