Provider Demographics
NPI:1851680409
Name:MARTINEZ, ERIN LEIGH (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:ERIN
Middle Name:LEIGH
Last Name:MARTINEZ
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:146 WRIGHTS MILL DR
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:MS
Mailing Address - Zip Code:39110-8436
Mailing Address - Country:US
Mailing Address - Phone:601-421-8669
Mailing Address - Fax:
Practice Address - Street 1:1073 HIGHWAY 51
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:MS
Practice Address - Zip Code:39110-9085
Practice Address - Country:US
Practice Address - Phone:601-605-0402
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-04-05
Last Update Date:2011-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MST-010015183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist