Individual
FREDERICK ROBERT MARTIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
6051 HIGHWAY 49, HATTIESBURG, MS 39401-7200
(601) 288-7000
Mailing address
PO BOX 15218, HATTIESBURG, MS 39404-5218
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
13861
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00120808
—
MS
Enumeration date
06/09/2006
Last updated
10/05/2007
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