Individual
DR. MARTIN D MARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3999 DUTCHMANS LN, SUITE 7B, LOUISVILLE, KY 40207-4729
(502) 896-4711
(502) 896-4791
Mailing address
PO BOX 776351, CHICAGO, IL 60677-6351
(502) 588-9490
(502) 272-5116
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
29138
KY
208600000X
Surgery Physician
Primary
29138
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000049919
ANTHEM PIN #
KY
05
—
201083450
—
IN
01
—
50034544
PASSPORT- NORTON SURGICAL SPECIALISTS
KY
05
—
64291388
—
KY
Enumeration date
03/28/2006
Last updated
07/12/2016
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us