Individual
MALLORY GLYNNIS MARTINEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
613 N 2ND ST, LAWRENCE, KS 66044-1407
(785) 842-7026
Mailing address
330 ARKANSAS ST, STE 210, LAWRENCE, KS 66044-1394
(785) 842-7026
Taxonomy
Speciality
Code
Description
License number
State
207LP2900X
Pain Medicine (Anesthesiology) Physician
Primary
04-39123
KS
207R00000X
Internal Medicine Physician
9407721
KS
Other
Enumeration date
07/04/2011
Last updated
09/04/2024
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