Provider Demographics
NPI:1235329889
Name:REYES MARTIN, FRANCISCO J (MD)
Entity Type:Individual
Prefix:DR
First Name:FRANCISCO
Middle Name:J
Last Name:REYES MARTIN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11109 PARKVIEW PLAZA DR # 117
Mailing Address - Street 2:
Mailing Address - City:FORT WAYNE
Mailing Address - State:IN
Mailing Address - Zip Code:46845-1701
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:885 W CONNEXION WAY STE 100
Practice Address - Street 2:
Practice Address - City:COLUMBIA CITY
Practice Address - State:IN
Practice Address - Zip Code:46725-1045
Practice Address - Country:US
Practice Address - Phone:260-248-2575
Practice Address - Fax:260-248-2726
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-30
Last Update Date:2022-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS04-35612208600000X
AZ82003390200000X
IN01072752A208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program