Provider Demographics
NPI:1477536985
Name:MARTIN, JAMES C JR (MD)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:C
Last Name:MARTIN
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:209 HOSPITAL DR STE 104
Mailing Address - Street 2:
Mailing Address - City:HIGHLANDS
Mailing Address - State:NC
Mailing Address - Zip Code:28741-7622
Mailing Address - Country:US
Mailing Address - Phone:288-526-4346
Mailing Address - Fax:288-526-2914
Practice Address - Street 1:209 HOSPITAL DR STE 104
Practice Address - Street 2:
Practice Address - City:HIGHLANDS
Practice Address - State:NC
Practice Address - Zip Code:28741-7622
Practice Address - Country:US
Practice Address - Phone:288-526-4346
Practice Address - Fax:828-526-2914
Is Sole Proprietor?:No
Enumeration Date:2005-11-29
Last Update Date:2023-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXJ3151207Y00000X
NC31168207YX0007X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207YX0007XAllopathic & Osteopathic PhysiciansOtolaryngologyPlastic Surgery within the Head & Neck
No207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX116959102Medicaid
TX116959102Medicaid
TX116959102Medicaid