Individual
ALFONSO J MARTINEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
19600 E 39TH ST S, INDEPENDENCE, MO 64057-2301
(816) 425-6084
(816) 873-1121
Mailing address
4911 S ARROWHEAD DRIVE, SUITE 201, INDEPENDENCE, MO 64055
(816) 478-8113
(816) 478-8108
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
R8566
MO
207RP1001X
Pulmonary Disease Physician
R8566
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
08700069
BCBS KANSAS CITY
—
05
—
201362456
—
MO
Enumeration date
07/13/2006
Last updated
02/07/2019
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