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General NPI Number Information
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NPI Number | 1497121750
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Entity Type | Individual
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Provider Name | BRIAN ROBERT MARTIN PHARMD
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Gender | Male
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Dates
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Enumeration Date | 08/20/2015
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Last Update Date | 05/22/2023
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Provider Practice Location Address
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Address Line | 3011 N MICHIGAN ST
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City | PITTSBURG
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State | KS
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Zip | 66762-2546
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Country | US
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Telephone | 620-231-2681
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Fax | 620-232-2532
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Provider Business Mailing Address
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Address Line | 3011 N MICHIGAN ST
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City | PITTSBURG
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State | KS
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Zip | 66762-2546
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Country | US
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Telephone | 620-231-2681
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Fax | 620-232-2532
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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 | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 2015025663
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License Number State | MO
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Taxonomy #2
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 19098
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License Number State | OK
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Taxonomy #3
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 1-16797
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License Number State | KS
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