Individual
DR. JONATHAN MARTIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1 TRILLIUM WAY, CORBIN, KY 40701-8727
(606) 523-8521
(606) 523-8742
Mailing address
5200 COMMERCE CROSSINGS DR, LOUISVILLE, KY 40229-2182
(502) 253-4966
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
52464
KY
2084P0800X
Psychiatry Physician
R3842
KY
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7100429370
—
KY
Enumeration date
07/29/2015
Last updated
12/03/2021
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