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Individual

DR. DAVID C MARTIN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
13375 JONES ST STE C, LAVONIA, GA 30553-1147
(706) 356-5439
(706) 356-5897
Mailing address
13375 JONES ST STE C, LAVONIA, GA 30553-1147
(706) 356-5439
(706) 356-5897

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
047486
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0004103643
AETNA
GA
05
00860219C
GA
01
10056443
AMERIGROUP
GA
01
309143
WELLCARE
GA
01
580633978009
ATHENS AREA HEALTH PLAN SELECT
GA
01
582652628
TRICARE
GA
Enumeration date
04/29/2010
Last updated
04/29/2010
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