Martin, Jack L

Martin, Jack L is an individual health care provider with primary practice located at 415 Wyntre Lea Dr , Bryn Mawr PA 19010-2038. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Cardiovascular Disease, Allopathic & Osteopathic Physicians / Interventional Cardiology. Allopathic & Osteopathic Physicians / Interventional Cardiology is his primary health care specialty. Martin, Jack L can be contacted via phone (610) 331-5849.

Contact Information

Primary practice address
415 Wyntre Lea Dr Bryn Mawr PA 19010-2038
Phone: (610) 331-5849
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Cardiovascular Disease 207RC0000X MD022890E Pennsylvania
Allopathic & Osteopathic Physicians / Cardiovascular Disease 207RC0000X M9484 Texas
Allopathic & Osteopathic Physicians / Interventional Cardiology 207RI0011X 129873-01 New York

Profile Details

NPI number 1942206214
LBN Legal business name Martin, Jack L
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 22nd, 2005
Last updated Jun 29th, 2022 - about 4 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 1942206214 NPPES
Texas Other 8F8997 MEDICARE INDIVIDUAL PTAN

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