Organization
DERRICK J MARTIN MD PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DERRICK J MARTIN SR. MD (PHYSICIAN)
(352) 751-8833
Entity
Organization
Contact information
Practice address
1501 N US HIGHWAY 441, BLDG 1800 SUITE 1832, THE VILLAGES, FL 32159-8999
(352) 751-8833
Mailing address
1501 N US HIGHWAY 441, BLDG 1800 SUITE 1832, THE VILLAGES, FL 32159-8999
(352) 751-8833
Taxonomy
Speciality
Code
Description
License number
State
282N00000X
General Acute Care Hospital
Primary
ME100133
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0803330
—
OH
Enumeration date
04/16/2008
Last updated
04/16/2008
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