Organization
MARTIN HEALTH CARE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. KELLEY MARTIN CFNP (NURSE PRACTITIONER- PRESIDENT)
(601) 845-6602
Entity
Organization
Contact information
Practice address
218 EAST MAIN ST, FLORENCE, MS 39073-0530
(601) 845-6602
(601) 845-6164
Mailing address
PO BOX 530, FLORENCE, MS 39073-0530
(601) 845-6602
(601) 845-6164
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
R814098
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
09016100
—
MS
Enumeration date
11/07/2007
Last updated
11/07/2007
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