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General NPI Number Information
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NPI Number | 1346290962
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Entity Type | Individual
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Provider Name | CYNTHIA EARHART MARTIN MD
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Gender | Female
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Dates
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Enumeration Date | 05/12/2006
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Last Update Date | 01/24/2024
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Provider Practice Location Address
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Address Line | 340 S WILLARD ST
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City | COTTONWOOD
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State | AZ
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Zip | 86326-4126
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Country | US
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Telephone | 928-639-6025
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Fax | 928-639-6541
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Provider Business Mailing Address
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Address Line | PO BOX 3630
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City | FLAGSTAFF
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State | AZ
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Zip | 86003-3630
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Country | US
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Telephone | 928-522-9400
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Fax | 928-774-4808
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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 | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | 32051
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License Number State | AZ
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Taxonomy #2
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 32051
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License Number State | AZ
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