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Individual

DR. WILLIAM ROBERT MARTIN III

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
4430 MISSOURI AVE, FORT LEONARD WOOD, MO 65473-9098
(735) 960-4175
Mailing address
4430 MISSOURI AVE, FORT LEONARD WOOD, MO 65473-9098
(573) 596-0417

Taxonomy

Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
22049
AZ
207X00000X
Orthopaedic Surgery Physician
Primary
7834
AK

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
083009
MEDICAID URGENT CARE
AZ
01
22049
STATE LICENSE
AZ
05
397621
AZ
01
P00217224
RAILROAD MEDICARE
AZ
01
Z84076
MEDICARE INDIVIDUAL PIN
AZ
01
Z84078
MEDICARE ID-PIN
AZ
Enumeration date
09/27/2005
Last updated
02/08/2023
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