Organization
JORGE A. MARTINEZ, MD, PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RENEE ROBLING (ADMINISTRATOR)
(208) 498-1700
Entity
Organization
Contact information
Practice address
1615 12TH AVE RD STE B, NAMPA, ID 83686-6184
(208) 498-1700
Mailing address
1615 12TH AVE RD STE B, NAMPA, ID 83686-6184
(208) 498-1700
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
—
—
207W00000X
Ophthalmology Physician
Primary
—
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000010150557
REGENCE BLUE SHIELD
ID
01
—
8L691
BLUE CROSS
ID
01
—
DD3339
RAILROAD MEDICARE
ID
Enumeration date
07/25/2006
Last updated
07/21/2008
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