Individual
DR. MARK A MARTIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
2112 PINESHORE CT, EVANSVILLE, IN 47711-4473
(812) 437-5554
(812) 437-5577
Mailing address
2112 PINESHORE CT, EVANSVILLE, IN 47711-4473
(812) 437-5554
(812) 437-5577
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
02002206A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000324829
BCBS WOUND CARE
IN
05
—
200355030A
—
IN
01
—
2296702
WELBORN HMO - WOUND CARE
IN
Enumeration date
02/07/2006
Last updated
07/16/2008
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