Provider Demographics
NPI:1285607879
Name:MARTIN, MARSTON CURTIS (OD)
Entity type:Individual
Prefix:DR
First Name:MARSTON
Middle Name:CURTIS
Last Name:MARTIN
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:925 MALLY ST
Mailing Address - Street 2:
Mailing Address - City:TUSCALOOSA
Mailing Address - State:AL
Mailing Address - Zip Code:35405-8785
Mailing Address - Country:US
Mailing Address - Phone:205-344-5111
Mailing Address - Fax:205-344-5004
Practice Address - Street 1:925 MALLY ST
Practice Address - Street 2:
Practice Address - City:TUSCALOOSA
Practice Address - State:AL
Practice Address - Zip Code:35405-8785
Practice Address - Country:US
Practice Address - Phone:205-344-5111
Practice Address - Fax:205-344-5004
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-13
Last Update Date:2013-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALS846TA372152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL000034313Medicaid
AL051034313OtherBLUE CROSS BLUE SHIELD
AL3919300001OtherDMERC
AL3919300001OtherDMERC
AL00034313Medicare PIN