Individual
MR. JAMES TINSLEY MARTIN III
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
2600 GREENWOOD RD, SHREVEPORT, LA 71103-3908
(318) 212-4000
Mailing address
192 FOUNTAIN VW, SHREVEPORT, LA 71118-2942
(318) 688-8637
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
AP04869
LA
367500000X
Certified Registered Nurse Anesthetist
CO2643
AR
Other
Enumeration date
02/23/2006
Last updated
07/08/2007
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