Provider Demographics
NPI:1710909049
Name:MARTIN, JAMES ALEXANDER (AUD)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:ALEXANDER
Last Name:MARTIN
Suffix:
Gender:M
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:480 23RD ST
Mailing Address - Street 2:
Mailing Address - City:ASHLAND
Mailing Address - State:KY
Mailing Address - Zip Code:41101-7858
Mailing Address - Country:US
Mailing Address - Phone:606-327-6202
Mailing Address - Fax:
Practice Address - Street 1:480 23RD ST
Practice Address - Street 2:
Practice Address - City:ASHLAND
Practice Address - State:KY
Practice Address - Zip Code:41101-7858
Practice Address - Country:US
Practice Address - Phone:606-327-6202
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-24
Last Update Date:2007-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KYKY-0334231H00000X
OH01147231H00000X
KY0770237600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
No237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid Fitter
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY50000108Medicaid