Provider Demographics
NPI:1205923109
Name:MARTIN, DONALD JOSEPH (MD)
Entity type:Individual
Prefix:DR
First Name:DONALD
Middle Name:JOSEPH
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 1:10116 W 105TH ST
Mailing Address - Street 2:
Mailing Address - City:OVERLAND PARK
Mailing Address - State:KS
Mailing Address - Zip Code:66212-5746
Mailing Address - Country:US
Mailing Address - Phone:913-541-0510
Mailing Address - Fax:913-541-1852
Practice Address - Street 1:10116 W 105TH ST
Practice Address - Street 2:
Practice Address - City:OVERLAND PARK
Practice Address - State:KS
Practice Address - Zip Code:66212-5746
Practice Address - Country:US
Practice Address - Phone:913-541-0510
Practice Address - Fax:913-541-1852
Is Sole Proprietor?:No
Enumeration Date:2006-10-10
Last Update Date:2022-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2008009086207RG0100X
KS04-38458207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology