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Individual

MR. JAMES ROBERT MARTIN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MPAS

Contact information

Practice address
1490 E FOREMASTER DR, STE 150, ST GEORGE, UT 84790-4488
(435) 628-9393
(435) 628-9382
Mailing address
1055 N 500 W, PROVO, UT 84604-3305
(435) 628-9393
(435) 628-9382

Taxonomy

Speciality
Code
Description
License number
State
2080A0000X
Pediatric Adolescent Medicine Physician
288527-1206
UT
363A00000X
Physician Assistant
Primary
288527-1206
UT

Other

Enumeration date
09/21/2006
Last updated
03/12/2015
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