Provider Demographics
NPI:1265688972
Name:JAMES H MARTIN JR MD PSC
Entity Type:Organization
Organization Name:JAMES H MARTIN JR MD PSC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BUSINESS CONSULTANT
Authorized Official - Prefix:
Authorized Official - First Name:BRENDA
Authorized Official - Middle Name:R
Authorized Official - Last Name:MARTIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:606-836-3770
Mailing Address - Street 1:900 SAINT CHRISTOPHER DR
Mailing Address - Street 2:SUITE 202
Mailing Address - City:ASHLAND
Mailing Address - State:KY
Mailing Address - Zip Code:41101-7090
Mailing Address - Country:US
Mailing Address - Phone:606-836-3770
Mailing Address - Fax:866-838-3770
Practice Address - Street 1:900 SAINT CHRISTOPHER DR
Practice Address - Street 2:SUITE 202
Practice Address - City:ASHLAND
Practice Address - State:KY
Practice Address - Zip Code:41101-7090
Practice Address - Country:US
Practice Address - Phone:606-836-3770
Practice Address - Fax:866-838-3770
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-08-13
Last Update Date:2016-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY000000042823OtherBLUE CROSS
OH0866068Medicaid
KYDT5414OtherMEDICARE RR
KYE93680Medicare UPIN
OH0866068Medicaid
KY65902702Medicare PIN