MEDICARE: JOSEPH CROSBY MARTIN 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	208600000X	Surgery Physician	24829	KY
2	208600000X	Surgery Physician	24961	CO

General Provider Information

NPI Number	:	1679854830
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOSEPH CROSBY MARTIN M.D.

Provider Business Mailing Address
First Line	:	1158 CLEVELAND AVE
Second Line	:
City	:	PARK HILLS
State	:	KY
Zip	:	41011-5606
Country	:	US
Telephone Number	:	859-292-8068
Fax Number	:	859-577-5784

Provider Business Practice Location Address
First Line	:	1158 CLEVELAND AVE
Second Line	:
City	:	PARK HILLS
State	:	KY
Zip	:	41011-5606
Country	:	US
Telephone Number	:	859-292-8068
Fax Number	:	859-261-7860

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

Provider Enumeration Date	:	09/01/2011
Last Update Date	:	02/04/2017

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Directions to “ JOSEPH CROSBY MARTIN M.D.” Practice Location

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