Individual
MATTHEW MARTIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1220 JEFFERSON ST, LAUREL, MS 39440-4355
(601) 428-0100
(601) 428-0100
Mailing address
PO BOX 247, LAUREL, MS 39441-0247
(601) 428-0100
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
32831
MS
Other
Enumeration date
03/29/2019
Last updated
04/23/2026
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