Provider Demographics
NPI:1346372232
Name:ARIBBE A. MARTIN, MD, PSC
Entity Type:Organization
Organization Name:ARIBBE A. MARTIN, MD, PSC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:ARIBBE
Authorized Official - Middle Name:A
Authorized Official - Last Name:MARTIN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:270-441-4506
Mailing Address - Street 1:2401 NEW HOLT RD
Mailing Address - Street 2:
Mailing Address - City:PADUCAH
Mailing Address - State:KY
Mailing Address - Zip Code:42001-7455
Mailing Address - Country:US
Mailing Address - Phone:270-441-4506
Mailing Address - Fax:270-441-4377
Practice Address - Street 1:225 MEDICAL CENTER DR
Practice Address - Street 2:SUITE 209A
Practice Address - City:PADUCAH
Practice Address - State:KY
Practice Address - Zip Code:42003-7914
Practice Address - Country:US
Practice Address - Phone:270-441-4506
Practice Address - Fax:270-441-4377
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-09
Last Update Date:2024-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY36761207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY641648001OtherCIGNA
000000196194OtherBS
KY7594235OtherAETNA
KY64033368Medicaid
KY1880301Medicare ID - Type UnspecifiedMEDICARE