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Individual

MR. ADRIAN P MARTIN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
305 W JACKSON ST STE 206, CARBONDALE, IL 62901-1474
(618) 457-3006
(618) 457-3007
Mailing address
PO BOX 3988, CARBONDALE, IL 62902-3988
(618) 457-5200

Taxonomy

Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
036115702
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
036115702
IL
01
120857
HEALTH ALLIANCE
IL
01
294010
HEALTHLINK
IL
01
324137
GHP
IL
01
3932056
BCBS OF IL
IL
01
7210895
AETNA
IL
Enumeration date
11/07/2006
Last updated
05/08/2025
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