Provider Demographics
NPI:1972589992
Name:MARTIN, JOHN PATRICK (MD)
Entity type:Individual
Prefix:DR
First Name:JOHN
Middle Name:PATRICK
Last Name:MARTIN
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:6231 LEESBURG PIKE
Mailing Address - Street 2:SUITE 608
Mailing Address - City:FALLS CHURCH
Mailing Address - State:VA
Mailing Address - Zip Code:22044-2102
Mailing Address - Country:US
Mailing Address - Phone:703-534-3900
Mailing Address - Fax:703-536-3729
Practice Address - Street 1:6231 LEESBURG PIKE
Practice Address - Street 2:SUITE 608
Practice Address - City:FALLS CHURCH
Practice Address - State:VA
Practice Address - Zip Code:22044-2102
Practice Address - Country:US
Practice Address - Phone:703-534-3900
Practice Address - Fax:703-536-3729
Is Sole Proprietor?:No
Enumeration Date:2005-12-21
Last Update Date:2012-05-23
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
VA0101221054207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA006307604Medicaid
VA006307604Medicaid