Provider Demographics
NPI:1538153879
Name:MARTIMBEAU, CLAUDE L (MD)
Entity type:Individual
Prefix:
First Name:CLAUDE
Middle Name:L
Last Name:MARTIMBEAU
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2713 SOUTH 74TH STREET
Mailing Address - Street 2:SUITE 204
Mailing Address - City:FORT SMITH
Mailing Address - State:AR
Mailing Address - Zip Code:72903
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2713 SOUTH 74TH STREET
Practice Address - Street 2:SUITE 204
Practice Address - City:FORT SMITH
Practice Address - State:AR
Practice Address - Zip Code:72903
Practice Address - Country:US
Practice Address - Phone:479-452-7175
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2005-09-01
Last Update Date:2008-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARR3830207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK100214850AMedicaid
AR113976001Medicaid
AR0408400001Medicare NSC
AR51993Medicare PIN
OK100214850AMedicaid