Individual
JOHN RAY MARTINEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
101 SKAGGS RD, SUITE 302, BRANSON, MO 65616-2075
(417) 334-8288
(417) 334-6966
Mailing address
101 SKAGGS RD, SUITE 302, BRANSON, MO 65616-2075
(417) 334-8288
(417) 334-6966
Taxonomy
Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
Primary
R2G43
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
130736001
—
AR
01
—
175334
BLUE CROSS MISSOURI
MO
05
—
207953324
—
MO
01
—
293593
HEALTHLINK
MO
01
—
390008665
RAILROAD MEDICARE
MO
Enumeration date
07/05/2006
Last updated
10/17/2019
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