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Individual

DR. JASON ROBERT MARTIN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
651 CENTRE VIEW BLVD, CRESTVIEW HILLS, KY 41017-5423
(859) 371-3376
(859) 331-1053
Mailing address
PO BOX 635283, CINCINNATI, OH 45263-5283
(859) 371-3376
(859) 331-1053

Taxonomy

Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
35-134208
OH
207N00000X
Dermatology Physician
Primary
53911
KY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0311385
OH
Enumeration date
04/30/2014
Last updated
02/05/2021
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