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General NPI Number Information
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NPI Number | 1417178740
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Entity Type | Organization
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Legal Business Name | JAMES B. MARTIN M.D. LLC
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Dates
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Enumeration Date | 05/02/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 1103 HANLEY RD
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City | OCEAN SPRINGS
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State | MS
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Zip | 39564-3108
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Country | US
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Telephone | 228-875-3097
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Fax | 228-875-3299
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Provider Business Mailing Address
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Address Line | 1103 HANLEY RD
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City | OCEAN SPRINGS
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State | MS
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Zip | 39564-3108
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Country | US
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Telephone | 228-875-3097
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Fax | 228-875-3299
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Authorized Official
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Title or Position | OWNER
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Name | CLARK LEVI
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Credential |
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Telephone | 228-875-3097
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | MS5001
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License Number State | MS
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