Provider Demographics
NPI:1962593202
Name:MARTIN, JEFFREY H (MD PA)
Entity type:Individual
Prefix:DR
First Name:JEFFREY
Middle Name:H
Last Name:MARTIN
Suffix:
Gender:M
Credentials:MD PA
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:75 MEDICAL PARK LN
Mailing Address - Street 2:SUITE A
Mailing Address - City:MURPHY
Mailing Address - State:NC
Mailing Address - Zip Code:28906-6667
Mailing Address - Country:US
Mailing Address - Phone:828-835-3900
Mailing Address - Fax:828-835-3006
Practice Address - Street 1:75 MEDICAL PARK LN
Practice Address - Street 2:SUITE A
Practice Address - City:MURPHY
Practice Address - State:NC
Practice Address - Zip Code:28906-6667
Practice Address - Country:US
Practice Address - Phone:828-835-3900
Practice Address - Fax:828-835-3006
Is Sole Proprietor?:No
Enumeration Date:2006-09-28
Last Update Date:2007-11-19
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NC9701477208800000X
GA056322208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
7598763OtherAETNA INSURANCE
1901307OtherUNITED HEALTH CARE
P00256390OtherMEDICARE RAIL ROAD
GA854396OtherBLUE CROSS/BLUE SHIELD
9203057845OtherHUMANA GOLD CHOICE
NC140R1OtherBLUE CROSS/BLUE SHIELD
NC5902636Medicaid
NC2043049Medicare PIN
9203057845OtherHUMANA GOLD CHOICE