Provider Demographics
NPI:1487834933
Name:JEFFREY H MARTIN MD PA
Entity Type:Organization
Organization Name:JEFFREY H MARTIN MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:H
Authorized Official - Last Name:MARTIN
Authorized Official - Suffix:
Authorized Official - Credentials:MD PA
Authorized Official - Phone:828-835-3900
Mailing Address - Street 1:75 MEDICAL PARK LN
Mailing Address - Street 2:#A
Mailing Address - City:MURPHY
Mailing Address - State:NC
Mailing Address - Zip Code:28906-6667
Mailing Address - Country:US
Mailing Address - Phone:828-835-3900
Mailing Address - Fax:828-835-3006
Practice Address - Street 1:75 MEDICAL PARK LN
Practice Address - Street 2:#A
Practice Address - City:MURPHY
Practice Address - State:NC
Practice Address - Zip Code:28906-6667
Practice Address - Country:US
Practice Address - Phone:828-835-3900
Practice Address - Fax:828-835-3006
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-13
Last Update Date:2013-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208800000XAllopathic & Osteopathic PhysiciansUrologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC2347666OtherNC MEDICARE GROUP PTAN
NC140R1OtherBLUE CROSS BLUE SHIELD
NC1901307OtherUNITED HEALTH CARE
NC2043049OtherNC MEDICARE INDIVIDUAL PTAN
NC5902636Medicaid
NC1901307OtherUNITED HEALTH CARE