Provider Demographics
NPI:1942287941
Name:MARTIN, RICK F (DPM)
Entity Type:Individual
Prefix:DR
First Name:RICK
Middle Name:F
Last Name:MARTIN
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:720 ALDINGER DR
Mailing Address - Street 2:
Mailing Address - City:DALLASTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:17313-9232
Mailing Address - Country:US
Mailing Address - Phone:717-968-5564
Mailing Address - Fax:
Practice Address - Street 1:720 ALDINGER DR
Practice Address - Street 2:
Practice Address - City:DALLASTOWN
Practice Address - State:PA
Practice Address - Zip Code:17313-9232
Practice Address - Country:US
Practice Address - Phone:717-968-5564
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-12-30
Last Update Date:2019-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASC002233L213E00000X, 213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
No213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0008884510001Medicaid
PA01792501OtherCAPITAL BLUE CROSS
PA415156HDXMedicare PIN
PA01792501OtherCAPITAL BLUE CROSS