Individual
LAURENCE MARTIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
CORNER OF ROUTE N12 AND N7, FORT DEFIANCE, AZ 86504
(928) 729-8710
Mailing address
P.O. BOX 589, FORT DEFIANCE INDIAN HOSPITAL BOARD, FORT DEFIANCE, AZ 86504
(928) 729-8000
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
27766
TN
Other
Enumeration date
06/09/2005
Last updated
10/23/2014
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