Robert Ambrose Martin
Family Doctor Family Doctor - Sports Medicine
380 S Davis Rd Suite E&f
LaGrange
, Georgia 30241-2588
Robert Ambrose Martin
Family Doctor Family Doctor - Sports Medicine
380 S Davis Rd Suite E&f
LaGrange
, Georgia 30241-2588
(706) 298-4989
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About
Features
Specialties
- Family Doctor
- Family Doctor - Sports Medicine
Languages spoken
- English
Location
First Address
- Robert Ambrose Martin
- 303 Smith St
- Lagrange, GA
- Zip : 30240-2745
- Fax : (706) 298-4989
- Phone : (706) 882-8831
Second Address
- Robert Ambrose Martin
- 380 S Davis Rd Suite E&f
- Lagrange, GA
- Zip : 30241-2588
- Fax : (706) 298-4989
- Phone : (706) 882-8831
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| N | 207Q00000X | Family Doctor | 32892 | SC |
| Y | 207QS0010X | Family Doctor - Sports Medicine | 071595 | GA |
National Provider Identifier
| NPI | 1073834404 |
|---|---|
| Provider Name | Robert Ambrose Martin |
| First Address | Lagrange, GA 30240-2745 |
| Second Address | Lagrange, GA 30241-2588 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 21/06/2010 |
| Last Update Date | 17/10/2014 |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.