# MARTIN JAY HERNANDEZ MD PC

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

## Provider details

- **NPI number:** 1932271996
- **Authorized official:** MARTIN JAY HERNANDEZ MD (OWNER)
- **Authorized official phone:** (623) 936-3223

## Contact information

- **Practice address:** 711 E MISSOURI AVE, SUITE 190, PHOENIX, AZ 85014-2841
- **Practice address phone:** (623) 936-3223
- **Practice address fax:** (623) 936-4554
- **Mailing address:** 711 E MISSOURI AVE, SUITE 190, PHOENIX, AZ 85014-2841
- **Mailing address phone:** (623) 936-3223
- **Mailing address fax:** (623) 936-4554

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | 31880 | AZ | Yes |

## Other

- **Enumeration date:** 11/14/2006
- **Last updated:** 11/21/2014

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 1932271996 | MEDICARE NPI | AZ |