Organization
MARTIN EAR NOSE & THROAT CLINIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RICHARD A MARTIN MD (OWNER PHYSICIAN)
(573) 335-6163
Entity
Organization
Contact information
Practice address
37 DOCTORS PARK, SUITE 1, CAPE GIRARDEAU, MO 63703-4956
(573) 332-7000
(573) 332-7005
Mailing address
37 DOCTORS PARK, SUITE 1, CAPE GIRARDEAU, MO 63703-4956
(573) 332-7000
(573) 332-7005
Taxonomy
Speciality
Code
Description
License number
State
207YX0905X
Otolaryngology/Facial Plastic Surgery Physician
Primary
R8494
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200764918
—
MO
Enumeration date
08/24/2011
Last updated
10/11/2011
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