Doctor Name: | DR. WILLIAM LEE MARTIN |
NPI Number: | 1043416431 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | PH D |
License Number: | 45-734 |
Business Practice Address: | 6901 Orchard Rd Ocean Springs, MS - 395642666 |
Business Phone Number: | 2288189463 |
Business Fax Number: | |
Mailing Address: | 6901 Orchard Rd, OCEAN SPRINGS |
State: | MS |
Postal Code: | 395642666 |
Phone Number: | 2288189463 |
Fax Number: | |
NPI Enumeration Date: | 06/22/2007 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 103TC0700X |
License Number: | 45-734 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MS |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Psychologist |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: |