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Individual

MICHAEL J MARTIN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
OD

Contact information

Practice address
4800 N 22ND ST, PHOENIX, AZ 85016-4701
(602) 508-4943
(602) 508-4830
Mailing address
4800 N 22ND ST, PHOENIX, AZ 85016-4701
(602) 508-4943
(602) 508-4830

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
817
AZ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
773938
AZ
Enumeration date
10/25/2006
Last updated
12/21/2016
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