Provider Demographics
NPI:1184622524
Name:THE FAMILY PRACTICE OF JAMES MARTIN, MD, P.C.
Entity type:Organization
Organization Name:THE FAMILY PRACTICE OF JAMES MARTIN, MD, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:L
Authorized Official - Last Name:MARTIN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:610-435-5241
Mailing Address - Street 1:1230 S CEDAR CREST BLVD STE 306
Mailing Address - Street 2:
Mailing Address - City:ALLENTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18103-6212
Mailing Address - Country:US
Mailing Address - Phone:610-435-5241
Mailing Address - Fax:
Practice Address - Street 1:1230 S CEDAR CREST BLVD STE 306
Practice Address - Street 2:
Practice Address - City:ALLENTOWN
Practice Address - State:PA
Practice Address - Zip Code:18103-6212
Practice Address - Country:US
Practice Address - Phone:610-435-5241
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-07-11
Last Update Date:2023-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD-064255-L207QA0000X, 207QA0505X, 207QG0300X, 207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
No207QA0000XAllopathic & Osteopathic PhysiciansFamily MedicineAdolescent MedicineGroup - Single Specialty
No207QA0505XAllopathic & Osteopathic PhysiciansFamily MedicineAdult MedicineGroup - Single Specialty
No207QG0300XAllopathic & Osteopathic PhysiciansFamily MedicineGeriatric MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PACK3781OtherRAILROAD MEDICARE
PA03094800OtherCAPITAL BLUECROSS GRP #
PA001360848OtherINDEPENDENCEBLUECROSS GRP
PAFA1360848OtherHIGHMARK BLUESHIELD GRP #
PACK3781OtherRAILROAD MEDICARE