Individual
ALAN P MARTIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
100 GROSS CRESCENT CIR, FORT OGLETHORPE, GA 30742-3643
(706) 858-2000
(865) 291-3228
Mailing address
PO BOX 634909, CINCINNATI, OH 45263-4909
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
003258
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3671874
—
TN
01
—
4068157
BCBS OF TENNESSEE
TN
05
—
95006177
—
KY
Enumeration date
07/05/2006
Last updated
11/15/2007
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