Organization
S.A.MARTIN, JR. OD PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SAMUEL A. MARTIN JR. OD PC (OPTOMETRIST/PRESIDENT)
(434) 392-8355
Entity
Organization
Contact information
Practice address
201 A ST, SUITE B, FARMVILLE, VA 23901-1613
(434) 392-8355
(434) 392-3042
Mailing address
201 A ST, SUITE B, FARMVILLE, VA 23901-1613
(434) 392-8355
(434) 392-3042
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
0618000089
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
009203095
—
VA
01
—
075554
BLUE CROSS BLUE SHIELD
VA
01
—
540001094
MEDICARE RAIL ROAD
VA
01
—
6271
DAVIS VISION
VA
01
—
8043928355
VSP
VA
01
—
VA0089
BLUE VIEW/EYE MED
VA
Enumeration date
06/13/2008
Last updated
08/29/2012
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