Provider Demographics
NPI:1821690074
Name:MARTIN, RACHEL E (DPM)
Entity type:Individual
Prefix:DR
First Name:RACHEL
Middle Name:E
Last Name:MARTIN
Suffix:
Gender:F
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13632 W HACKAMORE DR
Mailing Address - Street 2:
Mailing Address - City:PEORIA
Mailing Address - State:AZ
Mailing Address - Zip Code:85383-6177
Mailing Address - Country:US
Mailing Address - Phone:602-510-0952
Mailing Address - Fax:
Practice Address - Street 1:9220 E MOUNTAIN VIEW RD STE 102
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85258-5134
Practice Address - Country:US
Practice Address - Phone:623-536-9822
Practice Address - Fax:623-536-3448
Is Sole Proprietor?:Yes
Enumeration Date:2020-11-12
Last Update Date:2025-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN41000446A213ES0103X
AZPOD-001116213ES0103X, 213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ206504Medicaid