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NPI Code Detail

MEDICARE: JAMES ALTON MARTIN PH.D.

MEDICARE: JAMES ALTON MARTIN PH.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
1103TC0700XClinical PsychologistPSY-PSY-LIC-2505MT

General Provider Information

NPI Number : 1225062300
Entity Type Code : Individual
Provider Name (Legal Business Name) : JAMES ALTON MARTIN PH.D.
Provider Business Mailing Address
First Line : 221 5TH AVE S
Second Line :
City : GLASGOW
State : MT
Zip : 59230-2600
Country : US
Telephone Number : 770-536-0977
Fax Number : 770-536-0976
Provider Business Practice Location Address
First Line : 221 5TH AVE S
Second Line :
City : GLASGOW
State : MT
Zip : 59230-2600
Country : US
Telephone Number : 770-536-0977
Fax Number : 770-536-0976
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/11/2006
Last Update Date : 08/06/2024

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