Provider Demographics
NPI:1457674186
Name:MARTHA A PRICE MD PA
Entity Type:Organization
Organization Name:MARTHA A PRICE MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MARTHA
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:PRICE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:813-879-3334
Mailing Address - Street 1:3211 W AZEELE ST
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33609-3017
Mailing Address - Country:US
Mailing Address - Phone:813-879-3334
Mailing Address - Fax:813-353-1945
Practice Address - Street 1:3211 W AZEELE ST
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33609-3017
Practice Address - Country:US
Practice Address - Phone:813-879-3334
Practice Address - Fax:813-353-1945
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-03-09
Last Update Date:2010-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty