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General NPI Number Information
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NPI Number | 1336601723
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Entity Type | Individual
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Provider Name | TIMOTHY PAUL MARTIN FNP-C
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Gender | Male
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Dates
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Enumeration Date | 04/03/2019
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Last Update Date | 01/27/2026
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Provider Practice Location Address
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Address Line | 607 OLD HIGHWAY 24 W
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City | KOKOMO
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State | MS
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Zip | 39643-5052
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Country | US
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Telephone | 985-202-8812
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Fax |
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Provider Business Mailing Address
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Address Line | 607 OLD HIGHWAY 24 W
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City | KOKOMO
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State | MS
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Zip | 39643-5052
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Country | US
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Telephone | 985-205-8812
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Fax |
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 204457
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License Number State | LA
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 903370
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License Number State | MS
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