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General NPI Number Information
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NPI Number | 1629877220
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Entity Type | Individual
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Provider Name | JAMAL MARTIN
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Gender | Male
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Dates
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Enumeration Date | 03/07/2025
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Last Update Date | 03/07/2025
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Provider Practice Location Address
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Address Line | 301 MAIN ST STE 22222223
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City | BATON ROUGE
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State | LA
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Zip | 70801-1919
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Country | US
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Telephone | 504-266-6750
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Fax | 504-324-0403
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Provider Business Mailing Address
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Address Line | 1109 HOOTER RD
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City | BRIDGE CITY
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State | LA
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Zip | 70094-3468
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Country | US
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Telephone | 504-266-6750
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Fax | 504-324-0403
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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 | 376K00000X
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Taxonomy Name | Nurse's Aide
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License Number |
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License Number State |
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