Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207RN0300X | Nephrologist | DO.1286 | AL |
Y | 207RN0300X | Nephrologist | OS3923 | FL |
NPI | 1053314302 |
---|---|
Provider Name | Dr. James Peter Martin |
First Address | Pensacola, FL 32524-1037 |
Second Address | Pensacola, FL 32504-7152 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 31/05/2005 |
Last Update Date | 03/02/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
110233261 | FLORIDA RR MEDICARE (01) | FL |
261540100 | (05) | FL |
51866 | BLUE CROSS BLUE SHIELDS (01) | FL |
AM8315649 | DEA LICENSE (01) | FL |
C48064 | (02) | FL |
DO.1286 | MEDICAL LICENSE (01) | AL |
FM3421536 | DEA LICENSE (01) | AL |
OS3923 | MEDICAL LICENSE (01) | FL |