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General NPI Number Information
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NPI Number | 1841418803
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Entity Type | Organization
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Legal Business Name | DAVID W. MARTIN, M.D., P.S.C.
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Dates
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Enumeration Date | 04/23/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 255 CHURCH STREET SUITE 203
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City | PIKEVILLE
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State | KY
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Zip | 41501
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Country | US
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Telephone | 606-432-2872
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Fax | 606-432-1343
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Provider Business Mailing Address
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Address Line | PO BOX 3219
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City | PIKEVILLE
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State | KY
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Zip | 41502
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Country | US
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Telephone | 606-432-2872
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Fax | 606-432-1343
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Authorized Official
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Title or Position | OWNER
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Name | DAVID WENDELL MARTIN
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Credential | MD
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Telephone | 606-432-2872
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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 | 34359
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License Number State | KY
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