Individual
DR. MARTIN WAYNE CARPENTER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
709 MORGANTOWN AVE, FAIRMONT, WV 26554-4331
(304) 366-4721
(304) 366-4847
Mailing address
709 MORGANTOWN AVE, FAIRMONT, WV 26554-4331
(304) 366-4721
(304) 366-4847
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
1013-00
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3101032000
—
WV
Enumeration date
07/14/2005
Last updated
12/17/2009
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