Organization Name: | MELINDA M. MARTIN, M.D., P.L.L.C. |
NPI Number: | 1053525063 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | MELINDA MARIE MARTIN (PRESIDENT-OWNER OF PRACTICE) |
Mailing Address: | 907 Ainsworth Drive Prescott |
State: | AZ US |
Postal Code: | 863051607 |
Phone Number: | 9287770070 |
Fax Number: | 9284457163 |
NPI Enumeration Date: | 05/09/2007 |
NPI Last Update Date: | 02/27/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 207VG0400X |
License Number: | 21893 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | AZ |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | Obstetrics & Gynecology |
Taxonomy Specialization: | Gynecology |
Taxonomy Definition: |