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Individual

LARRY E MARTIN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
4003 KRESGE WAY, STE 228, LOUISVILLE, KY 40207
(502) 893-5100
(502) 893-8408
Mailing address
PO BOX 950248, LOUISVILLE, KY 40295-0248
(502) 489-5730
(502) 489-5753

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
19096
KY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
64190960
KY
01
C10892
RR MC GRP
Enumeration date
04/18/2006
Last updated
01/26/2015
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