MEDICARE: WILLIAM MARTIN MD

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	207W00000X	Ophthalmology Physician	ME142801	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MNODZ	OTHER	FL	FLORIDA BLUE ID
2	ME142801	OTHER	FL	STATE LICENSE
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1932189438
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	WILLIAM MARTIN MD

Provider Business Mailing Address
First Line	:	2889 10TH AVE N
Second Line	:	STE 306
City	:	PALM SPRINGS
State	:	FL
Zip	:	33461-3045
Country	:	US
Telephone Number	:	419-693-4444
Fax Number	:	419-697-2149

Provider Business Practice Location Address
First Line	:	2889 10TH AVE N STE 306
Second Line	:
City	:	PALM SPRINGS
State	:	FL
Zip	:	33461-3045
Country	:	US
Telephone Number	:	561-964-0707
Fax Number	:	561-293-8330

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

Provider Enumeration Date	:	01/19/2006
Last Update Date	:	01/10/2020

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Directions to “ WILLIAM MARTIN MD” Practice Location

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