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Individual

DR. KENNETH WAYNE MARTIN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
D.O.

Contact information

Practice address
4025 WESTMARK DR, DUBUQUE, IA 52002-2626
(563) 583-9300
Mailing address
1515 DELHI ST STE 100, DUBUQUE, IA 52001-6320

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
DO-04846
IA
207Q00000X
Family Medicine Physician
R-9616
IA

Other

Enumeration date
04/12/2013
Last updated
03/07/2023
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