Martin, Carol A

Martin, Carol A is an individual health care provider with primary practice located at 711 W Adams St , Black River Falls WI 54615-9108. She recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as her primary health care specialty. Martin, Carol A can be contacted via phone (715) 284-5361.

Contact Information

Primary practice address
711 W Adams St Black River Falls WI 54615-9108
Phone: (715) 284-5361
Fax: (715) 284-1390
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 35705 Wisconsin

Profile Details

NPI number 1326084690
LBN Legal business name Martin, Carol A
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 22nd, 2006
Last updated Mar 7th, 2023 - about 3 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 1326084690 NPPES
Wisconsin Other 35705 WISCONSIN LICENSE NUMBER
Wisconsin Other 84D66MA WISCONSIN LICENSE NUMBER
Wisconsin MEDICAID 32074500 WISCONSIN LICENSE NUMBER

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