Individual
SCOTT LANIER MARTIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
1040 SIERRA DR, STE 400, GREENWOOD, IN 46143-7240
(317) 528-4248
(317) 865-8314
Mailing address
19400 N CREEK DR, LYNWOOD, IL 60411-9608
(708) 474-0410
(708) 474-0328
Taxonomy
Speciality
Code
Description
License number
State
207QS0010X
Sports Medicine (Family Medicine) Physician
02003798A
IN
207QS0010X
Sports Medicine (Family Medicine) Physician
Primary
036124986
IL
Other
Enumeration date
11/23/2009
Last updated
01/23/2012
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