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General NPI Number Information
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NPI Number | 1477440592
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Entity Type | Organization
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Legal Business Name | DR. STEPHEN MARTIN LLC.
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Dates
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Enumeration Date | 06/20/2025
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Last Update Date | 12/21/2025
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Provider Practice Location Address
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Address Line | 1497 FAIR RD STE 103
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City | STATESBORO
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State | GA
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Zip | 30458-0823
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Country | US
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Telephone | 912-486-1163
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Fax | 912-486-1165
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Provider Business Mailing Address
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Address Line | PO BOX 164
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City | BROOKLET
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State | GA
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Zip | 30415-0164
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Country | US
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Telephone |
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Fax | 912-486-1165
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Authorized Official
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Title or Position | CEO
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Name | DR. STEPHEN MARTIN
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Credential | DO
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Telephone | 912-486-1163
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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