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NPI Code Detail

MEDICARE: DR. WAYNE L. MARTIN M.D.

MEDICARE: DR. WAYNE L. 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
1207P00000XEmergency Medicine Physician10785AL

General Provider Information

NPI Number : 1962450577
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. WAYNE L. MARTIN M.D.
Provider Business Mailing Address
First Line : 200 CORPORATE BLVD
Second Line : SUITE 201
City : LAFAYETTE
State : LA
Zip : 70508-3870
Country : US
Telephone Number : 800-893-9698
Fax Number :
Provider Business Practice Location Address
First Line : 29 L V STABLER DR
Second Line :
City : GREENVILLE
State : AL
Zip : 36037-3850
Country : US
Telephone Number : 334-284-2787
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/05/2006
Last Update Date : 07/08/2007

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