Individual
MR. JASON LLOYD MARTIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
FNP-C
Contact information
Practice address
2601 GETWELL RD STE 1, CORINTH, MS 38834-6762
(662) 287-7138
(662) 287-7157
Mailing address
100 HOSPITAL ST STE 100, BOONEVILLE, MS 38829-3354
(662) 554-2322
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
902498
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
09136238
—
MS
Enumeration date
01/25/2018
Last updated
07/08/2021
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