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NPI Code Detail

MEDICARE: DR. KRISTIN KAY MARTIN D.O.

MEDICARE: DR. KRISTIN KAY MARTIN D.O.
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
1207P00000XEmergency Medicine PhysicianE-6205AR
2207QA0401XAddiction Medicine (Family Medicine) PhysicianE-6205AR
3207Q00000XFamily Medicine PhysicianE-6205AR

General Provider Information

NPI Number : 1689835225
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. KRISTIN KAY MARTIN D.O.
Provider Business Mailing Address
First Line : 2600 W MAIN ST
Second Line :
City : RUSSELLVILLE
State : AR
Zip : 72801-2535
Country : US
Telephone Number : 833-479-4325
Fax Number : 479-207-9191
Provider Business Practice Location Address
First Line : 2600 W MAIN ST
Second Line :
City : RUSSELLVILLE
State : AR
Zip : 72801-2535
Country : US
Telephone Number : 833-479-4325
Fax Number : 479-207-9191
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/17/2008
Last Update Date : 04/16/2026

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