Individual
ELMER MARTIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1401 MADISON AVE, COVINGTON, KY 41011-3313
(859) 655-6100
(859) 655-6179
Mailing address
215 E 11TH ST, NEWPORT, KY 41071-2203
(859) 655-6100
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
29847
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
64084916
—
KY
Enumeration date
07/19/2005
Last updated
04/03/2021
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