Individual
DR. JERRY DARREL MARTIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
MDF1778
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00252T
BC
TX
05
—
114477604
—
TX
01
—
20044235
MCRR
TX
Enumeration date
04/11/2006
Last updated
03/04/2008
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