MEDICARE: MARTIN, PLUNKETT, MD, LLC

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	208800000X	Urology Physician

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
4	CK5465	OTHER	FL	MEDICARE RAILROAD

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	77493	OTHER	FL	BLUE CROSS BLUE SHIELD
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1508842204
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MARTIN, PLUNKETT, MD, LLC

Provider Business Mailing Address
First Line	:	545 BRENT LN
Second Line	:
City	:	PENSACOLA
State	:	FL
Zip	:	32503-2003
Country	:	US
Telephone Number	:	850-477-5437
Fax Number	:	850-477-3380

Provider Business Practice Location Address
First Line	:	545 BRENT LN
Second Line	:
City	:	PENSACOLA
State	:	FL
Zip	:	32503-2003
Country	:	US
Telephone Number	:	850-477-5437
Fax Number	:	850-477-3380

Authorized Official
Title or Position	:	OWNER
Name	:	HOWELL J. MARTIN
Credential	:	MD
Telephone Number	:	850-477-5437

Provider Enumeration Date	:	12/15/2005
Last Update Date	:	06/16/2018

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Directions to “MARTIN, PLUNKETT, MD, LLC ” Practice Location

Language	Start Address	Practice Location

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