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Individual

DR. ROBERT DONALD MARTIN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
DC

Contact information

Practice address
217 E BROADWAY BLVD, JOHNSTON CITY, IL 62951-1604
(619) 983-3900
Mailing address
217 E BROADWAY BLVD, P.O. BOX 267, JOHNSTON CITY, IL 62951-1604
(618) 983-3900

Taxonomy

Speciality
Code
Description
License number
State
111N00000X
Chiropractor
IL
111NR0200X
Radiology Chiropractor
IL
111NX0800X
Orthopedic Chiropractor
Primary
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
073-82002
BLUE CROSS/BLUE SHIELD
IL
Enumeration date
08/12/2006
Last updated
09/11/2025
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