Provider Demographics
NPI:1336196419
Name:SALMON, MARTIN JAY (MD)
Entity Type:Individual
Prefix:
First Name:MARTIN
Middle Name:JAY
Last Name:SALMON
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 1223
Mailing Address - Street 2:
Mailing Address - City:CALERA
Mailing Address - State:AL
Mailing Address - Zip Code:35040-1223
Mailing Address - Country:US
Mailing Address - Phone:205-685-8036
Mailing Address - Fax:205-685-8077
Practice Address - Street 1:3800 RIDGEWAY DR
Practice Address - Street 2:MAGNOLIA HALL
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35209-5506
Practice Address - Country:US
Practice Address - Phone:205-868-2096
Practice Address - Fax:205-868-2097
Is Sole Proprietor?:No
Enumeration Date:2006-05-27
Last Update Date:2008-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL00013122208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
ALB76241Medicare UPIN