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NPI Code Detail

MEDICARE: CRAIG T. MARTINSON

MEDICARE: CRAIG T. MARTINSON
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
1122300000XDentistDN011197GA

General Provider Information

NPI Number : 1710134960
Entity Type Code : Organization
Provider Name (Legal Business Name) : CRAIG T. MARTINSON
Provider Business Mailing Address
First Line : 1102 N COLUMBIA AVE
Second Line :
City : RINCON
State : GA
Zip : 31326-6807
Country : US
Telephone Number : 912-564-7107
Fax Number : 912-826-2432
Provider Business Practice Location Address
First Line : 1102 N COLUMBIA AVE
Second Line :
City : RINCON
State : GA
Zip : 31326-6807
Country : US
Telephone Number : 912-564-7107
Fax Number : 912-826-2432
Authorized Official
Title or Position : CEO
Name : DR. CRAIG T. MARTINSON
Credential :
Telephone Number : 912-564-7107
Provider Enumeration Date : 08/19/2008
Last Update Date : 08/19/2008

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Directions to “CRAIG T. MARTINSON ” Practice Location

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