Organization
GAINES C MARTIN MD PHD PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GAINES CHARLES MARTIN (OWNER)
(904) 637-0007
Entity
Organization
Contact information
Practice address
1409 KINGSLEY AVE STE 9G, ORANGE PARK, FL 32073-4579
(904) 637-0007
Mailing address
1409 KINGSLEY AVE STE 9G, ORANGE PARK, FL 32073-4579
(904) 637-0007
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Enumeration date
09/11/2007
Last updated
04/08/2020
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