Individual
WILLIAM R MARTIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2780 FREDERICA ST, OWENSBORO, KY 42301-5442
(270) 926-4100
Mailing address
2780 FREDERICA ST, OWENSBORO, KY 42301-5442
(270) 926-4100
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
34442
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000052291
ANTHEM
KY
01
—
200035230
RAILROAD MEDICARE
KY
05
—
64344427
—
KY
01
—
K005560
TRICARE
KY
Enumeration date
05/24/2005
Last updated
10/14/2024
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