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General NPI Number Information
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NPI Number | 1629303656
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Entity Type | Individual
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Provider Name | JEANINE M MARTIN DO
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Gender | Female
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Dates
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Enumeration Date | 10/08/2009
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Last Update Date | 01/04/2016
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Provider Practice Location Address
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Address Line | 1000 OCHSNER BLVD
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City | COVINGTON
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State | LA
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Zip | 70433-8107
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Country | US
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Telephone | 985-875-2828
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Fax |
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Provider Business Mailing Address
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Address Line | 1514 JEFFERSON HWY
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City | NEW ORLEANS
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State | LA
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Zip | 70121-2429
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Country | US
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Telephone | 504-842-4000
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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 | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | OS11170
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 257616
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License Number State | MA
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Taxonomy #3
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Taxonomy Code | 207RR0500X
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Taxonomy Name | Rheumatology Physician
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License Number | 257616
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License Number State | MA
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Taxonomy #4
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Taxonomy Code | 207RR0500X
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Taxonomy Name | Rheumatology Physician
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License Number | MD208100
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License Number State | LA
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