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Individual

DR. TIMOTHY WAYNE MARTIN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
1600 SW ARCHER RD, GAINESVILLE, FL 32610-0254
(352) 273-6575
(352) 273-7912
Mailing address
1600 SW ARCHER RD, GAINESVILLE, FL 32610-0254
(352) 273-6575
(352) 273-7912

Taxonomy

Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
ME124825
FL
207L00000X
Anesthesiology Physician
R-4477
AR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
015344900
FL
01
050049607
RAILROAD MEDICARE
AR
05
123974001
AR
Enumeration date
10/13/2006
Last updated
11/16/2015
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