Individual
KENNETH ALAN MARTIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
401 MATTHEW ST, EMERGENCY DEPARTMENT, MARIETTA, OH 45750-1635
(740) 374-1400
Mailing address
401 MATTHEW ST, EMERGENCY DEPARTMENT, MARIETTA, OH 45750
(740) 376-1939
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
3098
WV
207P00000X
Emergency Medicine Physician
Primary
34011850
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0129985
—
OH
Enumeration date
06/21/2012
Last updated
07/10/2020
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