Provider Demographics
NPI:1811949563
Name:MARTIN, JEFFERY MERLE (MD)
Entity type:Individual
Prefix:DR
First Name:JEFFERY
Middle Name:MERLE
Last Name:MARTIN
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:37 W SIERRA VISTA DR
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85013-1200
Mailing Address - Country:US
Mailing Address - Phone:602-957-8767
Mailing Address - Fax:602-265-5489
Practice Address - Street 1:901 E WILLETTA ST
Practice Address - Street 2:ROOM 2503
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85006-2727
Practice Address - Country:US
Practice Address - Phone:602-239-5166
Practice Address - Fax:602-239-2307
Is Sole Proprietor?:No
Enumeration Date:2006-05-17
Last Update Date:2017-02-09
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Provider Licenses
StateLicense IDTaxonomies
AZ283412080N0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080N0001XAllopathic & Osteopathic PhysiciansPediatricsNeonatal-Perinatal Medicine