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General NPI Number Information
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NPI Number | 1871883926
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Entity Type | Individual
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Provider Name | JILL MARIE MARTIN M.D.
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Gender | Female
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Dates
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Enumeration Date | 04/11/2011
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Last Update Date | 07/03/2023
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Provider Practice Location Address
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Address Line | 330 TURNER MCCALL BLVD SW STE 2000
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City | ROME
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State | GA
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Zip | 30165-5618
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Country | US
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Telephone | 706-291-5360
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Fax |
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Provider Business Mailing Address
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Address Line | 420 E 2ND AVE STE 103
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City | ROME
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State | GA
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Zip | 30161-3210
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Country | US
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Telephone | 706-509-3000
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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 | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number | 60512
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License Number State | MN
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Taxonomy #2
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Taxonomy Code | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number | 57968
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License Number State | WI
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Taxonomy #3
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Taxonomy Code | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number | 95068
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License Number State | GA
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