Individual
DR. KENNETH ANDREW MARTIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
5320 W. MARKHAM, LITTLE ROCK, AR 72205
(501) 975-5633
(501) 227-0710
Mailing address
5320 W. MARKHAM, LITTLE ROCK, AR 72205
(501) 975-5633
(501) 227-0710
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
C5425
AR
207XS0114X
Adult Reconstructive Orthopaedic Surgery Physician
C5425
AR
207XX0005X
Sports Medicine (Orthopaedic Surgery) Physician
C5425
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
105268001
—
AR
Enumeration date
04/20/2006
Last updated
08/19/2019
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