Martin, David A

Martin, David A is an individual health care provider with primary practice located at 3025 Fountain Dr Suite 100, Conway AR 72034-3684. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Martin, David A can be contacted via phone (501) 932-5060.

Contact Information

Primary practice address
3025 Fountain Dr Suite 100 Conway AR 72034-3684
Fax: (501) 552-5330
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X C6441 Arkansas

Profile Details

NPI number 1700863891
LBN Legal business name Martin, David A
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 29th, 2005
Last updated Dec 14th, 2012 - about 12 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 1700863891 NPPES
Arkansas MEDICAID 112251001

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