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General NPI Number Information
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NPI Number | 1104883693
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Entity Type | Individual
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Provider Name | ANDREW J MARTIN M.D.
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Gender | Male
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Dates
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Enumeration Date | 04/27/2006
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Last Update Date | 09/04/2025
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Provider Practice Location Address
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Address Line | 4301 W MARKHAM ST # 556
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City | LITTLE ROCK
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State | AR
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Zip | 72205-7101
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Country | US
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Telephone | 501-296-1095
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Fax | 501-526-5919
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Provider Business Mailing Address
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Address Line | 2316 ELLA LEE LN
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City | HOUSTON
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State | TX
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Zip | 77019-6309
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Country | US
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Telephone | 979-429-4322
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Fax | 903-209-2974
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2085R0204X
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Taxonomy Name | Vascular & Interventional Radiology Physician
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License Number | M2393
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | 66080
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License Number State | AZ
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Taxonomy #3
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | MD466458
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License Number State | PA
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Taxonomy #4
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | 25MA11513800
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License Number State | NJ
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Taxonomy #5
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | E-14051
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License Number State | AR
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Taxonomy #6
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | 26866
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License Number State | SC
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Taxonomy #7
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | M2393
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License Number State | TX
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Taxonomy #8
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Taxonomy Code | 2085R0204X
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Taxonomy Name | Vascular & Interventional Radiology Physician
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License Number | E-14051
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License Number State | AR
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