Physician Compare National (NPI:1811051600)

HEALTHCARE PROVIDER: VINCENT LEE MARTIN CHIROPRACTOR

Physician Compare National contains general information about individual eligible professionals (EPs) such as demographic information and Medicare quality program participation.

Individual Professional Information
NPI	1811051600
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	0042499568
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20110128000722
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	MARTIN
	Individual professional last name
Provider First Name	VINCENT
	Individual professional first name
Provider Middle Name	L
	Individual professional middle name
Provider Gender	M
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	PALMER COLLEGE CHIROPRACTIC - DAVENPORT
	Individual professional's medical school
Graduation Year	1979
	Individual professional's medical school graduation year
Primary Specialty	CHIROPRACTIC
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Line 1 Street Address	502 GENTILLY RD
	Group Practice or individual's line 1 address
City	STATESBORO
	Group Practice or individual's city
State	GA
	Group Practice or individual's state
Zip Code	304585149
	Group Practice or individual's zip code (9 digits when available)
Phone Number	4127646456
	Phone number is listed only when there is a single phone number available for the practice location address

Hospital(s) Affiliation Information
Professional Accepts Medicare Assignment	Y