Individual
FREDRICK ALLAN MARTIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
813 FOUNDERS PARK DR E STE 107, SPRINGDALE, AR 72762-6321
(479) 463-6600
(479) 463-6624
Mailing address
813 FOUNDERS PARK DR E STE 107, SPRINGDALE, AR 72762-6321
(479) 463-6600
(479) 463-6624
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
C-6262
AR
207QG0300X
Geriatric Medicine (Family Medicine) Physician
Primary
C6262
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
116105001
—
AR
Enumeration date
03/20/2006
Last updated
09/22/2023
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