Provider Demographics
NPI:1437210499
Name:MARTIN, ARIBBE ALLEN (MD)
Entity Type:Individual
Prefix:
First Name:ARIBBE
Middle Name:ALLEN
Last Name:MARTIN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:ARIBBE
Other - Middle Name:A
Other - Last Name:MARTIN-BURCH
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
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
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-13
Last Update Date:2024-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY36761207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY6411648001OtherCIGNA
KY000000196194OtherBCBS
KY64033368Medicaid
KY7594235OtherAETNA
KY1880301Medicare ID - Type UnspecifiedMEDICARE
KY64033368Medicaid