Individual
DR. LYNETTE K. MARTIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
2200 E. PARRISH AVE, BLDG B, STE. 101, OWENSBORO, KY 42303-1449
(270) 683-3232
(270) 852-1600
Mailing address
2200 E. PARRISH AVE, BLDG B, STE 101, OWENSBORO, KY 42303-1449
(270) 683-3232
(270) 852-1600
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
34360
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00000051443
ID BLUE CROSS INSURANCE
KY
01
—
00000051443
BLUE CROSS
—
01
—
50004897
PASS-PORT NON-PARTCIPATE
KY
05
—
64343601
—
KY
Enumeration date
09/20/2005
Last updated
09/18/2023
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