Doctor Name: | DR. ROBERTO MARTINEZ |
NPI Number: | 1821299603 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | M.D. |
License Number: | 14370 |
Business Practice Address: | 2225 Haley Barbour Pkwy Yazoo City, MS - 391944796 |
Business Phone Number: | 6627161020 |
Business Fax Number: | 6627161053 |
Mailing Address: | 145 Bradshaw Crossing, CANTON |
State: | MS |
Postal Code: | 39046 |
Phone Number: | 6016050984 |
Fax Number: | |
NPI Enumeration Date: | 05/30/2007 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | 14370 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | PR |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |