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General NPI Number Information
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NPI Number | 1447684972
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Entity Type | Organization
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Legal Business Name | DR MARTINS FOOT AND ANKLE CLINIC
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Dates
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Enumeration Date | 09/03/2013
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Last Update Date | 09/25/2023
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Provider Practice Location Address
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Address Line | 1325 N MAIN ST
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City | ADRIAN
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State | MI
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Zip | 49221-1721
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Country | US
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Telephone | 517-879-4242
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Fax | 517-879-4240
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Provider Business Mailing Address
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Address Line | 1325 N MAIN ST
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City | ADRIAN
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State | MI
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Zip | 49221-1721
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Country | US
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Telephone | 517-879-4242
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Fax | 517-879-4240
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Authorized Official
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Title or Position | PODIATRIST
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Name | DR. DARRYL J MARTINS
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Credential | DPM
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Telephone | 517-879-4241
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 213E00000X
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Taxonomy Name | Podiatrist
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License Number | 5901002348
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License Number State | MI
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