Individual
EDWARD J MARTIN III
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1141 WHITNEY AVE, GRETNA, LA 70056-5011
(504) 361-3757
(504) 361-3132
Mailing address
PO BOX 731280, DALLAS, TX 75373-1280
(318) 841-9526
Taxonomy
Speciality
Code
Description
License number
State
207ZP0101X
Anatomic Pathology Physician
Primary
018796
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1922099
—
LA
Enumeration date
06/23/2006
Last updated
06/02/2016
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