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General NPI Number Information
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NPI Number | 1366298713
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Entity Type | Individual
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Provider Name | ROBERT LEE MARTIN III D.O.
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Gender | Male
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Dates
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Enumeration Date | 04/26/2024
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Last Update Date | 04/26/2024
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Provider Practice Location Address
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Address Line | 1303 WASHINGTON ST
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City | MARION
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State | AL
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Zip | 36756-3217
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Country | US
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Telephone | 205-920-2998
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Fax |
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Provider Business Mailing Address
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Address Line | 8175 CORALBERRY LN W
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City | JACKSONVILLE
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State | FL
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Zip | 32244-6110
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Country | US
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Telephone | 334-763-0357
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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 | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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