Provider Demographics
NPI:1710976493
Name:MARTIN, JANA MARIE (MD)
Entity Type:Individual
Prefix:DR
First Name:JANA
Middle Name:MARIE
Last Name:MARTIN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:MS
Other - First Name:JANA
Other - Middle Name:MARIE
Other - Last Name:HINDS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:1920 MALVERN AVE
Mailing Address - Street 2:
Mailing Address - City:HOT SPRINGS
Mailing Address - State:AR
Mailing Address - Zip Code:71901-7752
Mailing Address - Country:US
Mailing Address - Phone:501-321-1314
Mailing Address - Fax:501-321-1810
Practice Address - Street 1:1920 MALVERN AVE
Practice Address - Street 2:
Practice Address - City:HOT SPRINGS
Practice Address - State:AR
Practice Address - Zip Code:71901-7752
Practice Address - Country:US
Practice Address - Phone:501-321-1314
Practice Address - Fax:501-321-1810
Is Sole Proprietor?:No
Enumeration Date:2005-10-17
Last Update Date:2011-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARR4078208000000X
TXH2567208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR117170001Medicaid
AR117170001Medicaid