Provider Demographics
NPI:1568664589
Name:MARTIN, ABIGAIL E (MD)
Entity Type:Individual
Prefix:DR
First Name:ABIGAIL
Middle Name:E
Last Name:MARTIN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:800 ROSE ST # MS 0465
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40536-0191
Mailing Address - Country:US
Mailing Address - Phone:859-323-5625
Mailing Address - Fax:302-651-4945
Practice Address - Street 1:740 S LIMESTONE
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40536-3607
Practice Address - Country:US
Practice Address - Phone:859-218-2522
Practice Address - Fax:859-323-3918
Is Sole Proprietor?:No
Enumeration Date:2007-06-01
Last Update Date:2023-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEC100010447204F00000X
NC2009-01485204F00000X, 208600000X, 2086S0120X
NJ25MA07434600204F00000X, 2086S0120X
PAMD448939204F00000X
FLME126220204F00000X, 208600000X, 2086S0120X
KY577102086S0120X
RIMD123702086S0120X
KYTP3572086S0120X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0120XAllopathic & Osteopathic PhysiciansSurgeryPediatric Surgery
No204F00000XAllopathic & Osteopathic PhysiciansTransplant Surgery
No208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0387258Medicaid
PA102901546Medicaid
MD325309100Medicaid
PA358075SAJOtherMEDICARE
NC5912040Medicaid