Organization
MARTIN JAY HERNANDEZ MD PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARTIN JAY HERNANDEZ MD (OWNER)
(623) 936-3223
Entity
Organization
Contact information
Practice address
711 E MISSOURI AVE, SUITE 190, PHOENIX, AZ 85014-2841
(623) 936-3223
(623) 936-4554
Mailing address
711 E MISSOURI AVE, SUITE 190, PHOENIX, AZ 85014-2841
(623) 936-3223
(623) 936-4554
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
31880
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1932271996
MEDICARE NPI
AZ
Enumeration date
11/14/2006
Last updated
11/21/2014
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