Individual
DR. JEFFERY L MARTIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
406 AMES ST, BALDWIN CITY, KS 66006-3099
(785) 594-2512
Mailing address
737 N 1550 RD, LAWRENCE, KS 66049-9198
(785) 766-2158
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
04-18249
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
021119
BCBS OF KS
KS
05
—
100138770
—
KS
Enumeration date
12/01/2005
Last updated
12/15/2011
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