Provider Demographics
NPI:1528007838
Name:CAREY, MARTIN JOHN (MB, BCH)
Entity Type:Individual
Prefix:DR
First Name:MARTIN
Middle Name:JOHN
Last Name:CAREY
Suffix:
Gender:M
Credentials:MB, BCH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 BRIAR PATCH CT
Mailing Address - Street 2:
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72211-4425
Mailing Address - Country:US
Mailing Address - Phone:501-228-5029
Mailing Address - Fax:501-228-4703
Practice Address - Street 1:1 BRIAR PATCH CT
Practice Address - Street 2:
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72211-4425
Practice Address - Country:US
Practice Address - Phone:501-228-5029
Practice Address - Fax:501-228-4703
Is Sole Proprietor?:No
Enumeration Date:2006-06-05
Last Update Date:2010-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARE0917207PE0004X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207PE0004XAllopathic & Osteopathic PhysiciansEmergency MedicineEmergency Medical Services
Provider Identifiers
StateIdentifier IDID TypeIssuer
ARP00762275OtherRAILROAD MCARE THRU WCMC
AR129789001Medicaid
AR5K122Medicare ID - Type Unspecified
AR129789001Medicaid
AR5K122B637Medicare PIN