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General NPI Number Information
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NPI Number | 1700154093
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Entity Type | Organization
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Legal Business Name | JOSEPH H. MARTIN, JR., MD, LLC
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Dates
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Enumeration Date | 12/01/2011
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Last Update Date | 12/01/2011
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Provider Practice Location Address
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Address Line | 550 PEACHTREE ST NE STE 1420
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City | ATLANTA
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State | GA
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Zip | 30308-2241
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Country | US
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Telephone | 404-526-9111
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Fax | 404-526-9053
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Provider Business Mailing Address
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Address Line | PO BOX 54306
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City | ATLANTA
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State | GA
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Zip | 30308-0306
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Country | US
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Telephone | 404-526-9111
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Fax | 404-526-9053
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Authorized Official
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Title or Position | PROPRIETOR
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Name | JOSEPH H MARTIN JR.
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Credential | MD
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Telephone | 404-526-9111
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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 | 025795
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License Number State | GA
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