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Individual

DR. REBECCA EDGE MARTIN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
4300 W 7TH ST, LITTLE ROCK, AR 72205-5446
(501) 257-5778
Mailing address
6 LORETTA CIR, LITTLE ROCK, AR 72227-5953
(501) 257-5778

Taxonomy

Speciality
Code
Description
License number
State
207RI0200X
Infectious Disease Physician
Primary
C5785
AR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1100069008
MEDICARE RAILROAD
AR
05
111259001
AR
Enumeration date
09/06/2006
Last updated
06/17/2008
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