Individual
VINCENT E MARTIN JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
702 N MAIN ST, OPP, AL 36467-1626
(334) 493-2342
(334) 493-2552
Mailing address
702 N MAIN ST, OPP, AL 36467-1626
(334) 493-2342
(334) 493-2552
Taxonomy
Speciality
Code
Description
License number
State
2085B0100X
Body Imaging Physician
00015250
AL
2085N0904X
Nuclear Radiology Physician
00015250
AL
2085R0202X
Diagnostic Radiology Physician
Primary
00015250
AL
2085U0001X
Diagnostic Ultrasound Physician
00015250
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
051556337
—
AL
01
—
51002202
BLUE CROSS BLUE SHIELD
AL
01
—
P00240172
RAILROAD MEDICARE
AL
Enumeration date
11/29/2005
Last updated
10/19/2011
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