# MARTIN FAMILY PRACTICE PC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1902091143
- **Authorized official:** MARK A MARTIN D.O. (PHYSICIAN)
- **Authorized official phone:** (812) 437-5554

## Contact information

- **Practice address:** 4405 BELLEMEADE AVE, STE 102, EVANSVILLE, IN 47714-0682
- **Practice address phone:** (812) 437-5554
- **Practice address fax:** (812) 437-5577
- **Mailing address:** 4405 BELLEMEADE AVE, EVANSVILLE, IN 47714-0682
- **Mailing address phone:** (812) 437-5554
- **Mailing address fax:** (812) 437-5577

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | 02002206A | IN | Yes |

## Other

- **Enumeration date:** 09/11/2007
- **Last updated:** 10/08/2013