Mark, Martin D

Mark, Martin D is an individual health care provider with primary practice located at 3999 Dutchmans Ln Suite 7B, Louisville KY 40207-4729. He recently has 2 registered licenses in different health care specialties including Other Service Providers / Specialist, Allopathic & Osteopathic Physicians / Surgery. Allopathic & Osteopathic Physicians / Surgery is his primary health care specialty. Mark, Martin D can be contacted via phone (502) 896-4711.

Contact Information

Primary practice address
3999 Dutchmans Ln Suite 7B Louisville KY 40207-4729
Phone: (502) 896-4711
Fax: (502) 896-4791
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Specialist 174400000X 29138 Kentucky
Allopathic & Osteopathic Physicians / Surgery 208600000X 29138 Kentucky

Profile Details

NPI number 1457312894
LBN Legal business name Mark, Martin D
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 28th, 2006
Last updated Jul 12th, 2016 - about 10 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1457312894 NPPES
Kentucky Other 000000049919 ANTHEM PIN #
Kentucky MEDICAID 64291388 ANTHEM PIN #
Kentucky MEDICAID 201083450 ANTHEM PIN #
Kentucky Other 50034544 ANTHEM PIN #

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