Provider Demographics
NPI:1760799431
Name:MARTIN, JOSEPH ALVIN (MD)
Entity Type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:ALVIN
Last Name:MARTIN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:627 EASTLAND AVE SE STE 201
Mailing Address - Street 2:
Mailing Address - City:WARREN
Mailing Address - State:OH
Mailing Address - Zip Code:44484-4501
Mailing Address - Country:US
Mailing Address - Phone:330-841-4477
Mailing Address - Fax:330-841-4505
Practice Address - Street 1:627 EASTLAND AVE SE STE 201
Practice Address - Street 2:
Practice Address - City:WARREN
Practice Address - State:OH
Practice Address - Zip Code:44484-4501
Practice Address - Country:US
Practice Address - Phone:330-841-4477
Practice Address - Fax:330-841-4505
Is Sole Proprietor?:No
Enumeration Date:2010-09-01
Last Update Date:2023-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35.123710208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0106473Medicaid
OHH343420OtherMEDICARE PTAN