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1225025968

NPI Code Detail

MEDICARE: DR. WILLIAM ROBERT MARTIN III M.D.

MEDICARE: DR. WILLIAM ROBERT MARTIN III M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207X00000X	Orthopaedic Surgery Physician	22049	AZ
2	207X00000X	Orthopaedic Surgery Physician	7834	AK

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	P00217224	OTHER	AZ	RAILROAD MEDICARE
3	Z84076	OTHER	AZ	MEDICARE INDIVIDUAL PIN
6	Z84078	OTHER	AZ	MEDICARE ID-PIN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	22049	OTHER	AZ	STATE LICENSE
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
5	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1225025968
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. WILLIAM ROBERT MARTIN III M.D.

Provider Business Mailing Address
First Line	:	4430 MISSOURI AVE
Second Line	:
City	:	FORT LEONARD WOOD
State	:	MO
Zip	:	65473-9098
Country	:	US
Telephone Number	:	573-596-0417
Fax Number	:

Provider Business Practice Location Address
First Line	:	4430 MISSOURI AVE
Second Line	:
City	:	FORT LEONARD WOOD
State	:	MO
Zip	:	65473-9098
Country	:	US
Telephone Number	:	735-960-4175
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/27/2005
Last Update Date	:	02/08/2023

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Directions to “ DR. WILLIAM ROBERT MARTIN III M.D.” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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