Individual
LINUS MARTIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1001 HOLLAND AVE, PHILADELPHIA, MS 39350-2161
(601) 663-1200
(601) 663-1379
Mailing address
PO BOX 648, PHILADELPHIA, MS 39350-0648
(601) 663-1200
(601) 663-1379
Taxonomy
Speciality
Code
Description
License number
State
207PE0004X
Emergency Medical Services (Emergency Medicine) Physician
Primary
16527
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00122762
—
MS
Enumeration date
06/22/2006
Last updated
07/08/2007
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