Provider Demographics
NPI:1982689600
Name:MARTIN, J PAUL (MD)
Entity Type:Individual
Prefix:DR
First Name:J
Middle Name:PAUL
Last Name:MARTIN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 5200
Mailing Address - Street 2:
Mailing Address - City:ASHEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28813-5200
Mailing Address - Country:US
Mailing Address - Phone:828-258-3146
Mailing Address - Fax:
Practice Address - Street 1:155 BILTMORE AVE
Practice Address - Street 2:
Practice Address - City:ASHEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28801-4105
Practice Address - Country:US
Practice Address - Phone:828-259-5693
Practice Address - Fax:828-259-5711
Is Sole Proprietor?:Yes
Enumeration Date:2005-12-15
Last Update Date:2011-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC26310207Q00000X, 207QA0401X, 2083X0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207QA0401XAllopathic & Osteopathic PhysiciansFamily MedicineAddiction Medicine
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No2083X0100XAllopathic & Osteopathic PhysiciansPreventive MedicineOccupational Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC8954254Medicaid
NC54254OtherBCBS PROVIDER NUMBER
NC54254OtherBCBS PROVIDER NUMBER
208528CMedicare ID - Type Unspecified