Individual
PROF. WAYNE ROBERT MARTIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1606 N PANORAMA WAY, COCHISE, AZ 85606-8685
(701) 880-0826
Mailing address
1606 N PANORAMA WAY, COCHISE, AZ 85606-8685
(701) 880-0826
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
42227
AZ
207Q00000X
Family Medicine Physician
Primary
7466
MT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
8V4761
BCBS
TX
Enumeration date
06/08/2006
Last updated
10/31/2023
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