Individual
KENISHA ROCHELLE MARTIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1225 N STATE ST, JACKSON, MS 39202-2064
(601) 988-5281
Mailing address
965 RIDGE LAKE BLVD STE 103, MEMPHIS, TN 38120-9446
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
20535
MS
Other
Enumeration date
01/04/2007
Last updated
07/08/2020
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