Provider Demographics
NPI:1902339286
Name:URQUIJO, MARTYN (MD)
Entity type:Individual
Prefix:
First Name:MARTYN
Middle Name:
Last Name:URQUIJO
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 1:3057 W CAMINO FRESCO
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85746-8380
Mailing Address - Country:US
Mailing Address - Phone:520-509-5256
Mailing Address - Fax:
Practice Address - Street 1:4801 ALBERTA AVE
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79905-2707
Practice Address - Country:US
Practice Address - Phone:607-691-5215
Practice Address - Fax:915-545-7338
Is Sole Proprietor?:No
Enumeration Date:2017-04-04
Last Update Date:2025-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMRS2021-0707207Q00000X, 390200000X
390200000X
TXBP10094700390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine