Martin, Stacy Ann
Martin, Stacy Ann is an individual health care provider with primary practice located at 170 North 1100 East , American Fork UT 84003. She recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Emergency Medicine, Allopathic & Osteopathic Physicians / Emergency Medical Services. Allopathic & Osteopathic Physicians / Emergency Medical Services is her primary health care specialty. Martin, Stacy Ann can be contacted via phone (801) 714-6570.Contact Information
Primary practice address
170 North 1100 East
American Fork UT 84003
Phone: (801) 714-6570
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Emergency Medicine | 207P00000X | EMTL-2020-001 | Guam |
| Allopathic & Osteopathic Physicians / Emergency Medicine | 207P00000X | MTL-2018-027 | Guam |
| Allopathic & Osteopathic Physicians / Emergency Medicine | 207P00000X | M-2221 | Guam |
| Allopathic & Osteopathic Physicians / Emergency Medical Services | 207PE0004X | 341513 | Utah |
Profile Details
| NPI number | 1891748315 |
|---|---|
| LBN Legal business name | Martin, Stacy Ann |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | May 18th, 2006 |
| Last updated | Apr 9th, 2021 - 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1891748315 | NPPES |
| Utah | Other | 491910 | DESERET MUTUAL |
| Utah | Other | 97341513101001 | DESERET MUTUAL |
| Utah | Other | 107008020102 | DESERET MUTUAL |
| Utah | MEDICAID | D2015 | DESERET MUTUAL |
| Utah | Other | 870636000MA1 | DESERET MUTUAL |
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