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General NPI Number Information
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NPI Number | 1992298616
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Entity Type | Individual
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Provider Name | STEPHEN R. MARTIN DO, MPA, MSHSA
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Gender | Male
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Dates
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Enumeration Date | 06/07/2018
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Last Update Date | 12/21/2025
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Provider Practice Location Address
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Address Line | 1499 FAIR RD. DEPARTMENT OF WOUND CARE AND HYPERBARIC MEDICINE
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City | STATESBORO
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State | GA
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Zip | 30458
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Country | US
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Telephone | 912-486-1163
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Fax | 970-660-0912
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Provider Business Mailing Address
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Address Line | 1499 FAIR RD. DEPARTMENT OF WOUND CARE AND HYPERBARIC MEDICINE
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City | STATESBORO
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State | GA
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Zip | 30458
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Country | US
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Telephone | 912-486-1163
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Fax | 912-486-1163
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 34.015513
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License Number State | OH
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