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Individual

DR. WILLIAM GREGORY MARTIN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
O.D.

Contact information

Practice address
3220 IRVIN COBB DR, PADUCAH, KY 42003-0337
(270) 442-5342
Mailing address
PO BOX 3086, PADUCAH, KY 42002-3086
(270) 442-5342

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
1219 DT
KY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
77012193
KY
Enumeration date
02/14/2007
Last updated
07/08/2007
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