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NPI Code Detail

MEDICARE: DR. TREVOR R. MARTIN D.O.

MEDICARE:  DR. TREVOR R. 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
1207Q00000XFamily Medicine Physician125.053253IL
2207Q00000XFamily Medicine Physician036.123879IL
3207Q00000XFamily Medicine Physician4061IA

General Provider Information

NPI Number : 1770725202
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. TREVOR R. MARTIN D.O.
Provider Business Mailing Address
First Line : PO BOX 909
Second Line :
City : WASHINGTON
State : IA
Zip : 52353-0909
Country : US
Telephone Number : 319-653-7291
Fax Number : 319-653-7440
Provider Business Practice Location Address
First Line : 1230 S IOWA AVE
Second Line :
City : WASHINGTON
State : IA
Zip : 52353-1144
Country : US
Telephone Number : 319-653-7291
Fax Number : 319-653-7440
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/30/2009
Last Update Date : 04/30/2014

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Directions to “ DR. TREVOR R. MARTIN D.O.” Practice Location

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