Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207X00000X | Orthopaedic Surgeon | 34.014277 | OH |
N | 207XX0004X | Foot and Ankle Orthopaedic Surgeon | 1307020 | IA |
NPI | 1659535912 |
---|---|
Provider Name | Kevin Martin |
First Address | Columbus, OH 43202-1559 |
Second Address | Columbus, OH 43203-1278 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/07/2008 |
Last Update Date | 19/03/2021 |