Provider Demographics
NPI:1386665172
Name:JEFFREY D MARTENS MD PC
Entity Type:Organization
Organization Name:JEFFREY D MARTENS MD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:D
Authorized Official - Last Name:MARTENS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:724-349-6540
Mailing Address - Street 1:1177 SOUTH 6TH STREET
Mailing Address - Street 2:SUITE B
Mailing Address - City:INDIANA
Mailing Address - State:PA
Mailing Address - Zip Code:15701
Mailing Address - Country:US
Mailing Address - Phone:724-349-6540
Mailing Address - Fax:724-349-8207
Practice Address - Street 1:1177 SOUTH 6TH STREET
Practice Address - Street 2:SUITE B
Practice Address - City:INDIANA
Practice Address - State:PA
Practice Address - Zip Code:15701
Practice Address - Country:US
Practice Address - Phone:724-349-6540
Practice Address - Fax:724-349-8207
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-21
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty