Individual
DR. ELIZABETH ANNE MARTIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
O.D.
Contact information
Practice address
1330 INTERSTATE PARKWAY, AUGUSTA, GA 30909
(706) 651-2020
(706) 855-6674
Mailing address
1330 INTERSTATE PARKWAY, AUGUSTA, GA 30909
(706) 651-2020
(706) 855-6674
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
MA4591
MA
152W00000X
Optometrist
MN 3191
MN
152W00000X
Optometrist
Primary
OPT002811
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
202I412570
MEDICARE PTAN
GA
Enumeration date
08/31/2006
Last updated
05/28/2015
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