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:
Health care specialties
| Specialty | Code | License # | 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 2 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1942206214 | NPPES |
| Texas | Other | 8F8997 | MEDICARE INDIVIDUAL PTAN |
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