Individual
THOMAS RICHARD MARTIN JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1505 US HIGHWAY 431, BOAZ, AL 35957-1547
(256) 840-9834
Mailing address
500 CORLEY AVE, BOAZ, AL 35957-5954
(256) 593-1610
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
00011044
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00033487
—
AL
Enumeration date
07/19/2005
Last updated
07/08/2007
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