Provider Demographics
NPI:1538432281
Name:J FRANK MARTIN JR MD LLC
Entity type:Organization
Organization Name:J FRANK MARTIN JR MD LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:FRANK
Authorized Official - Last Name:MARTIN
Authorized Official - Suffix:JR
Authorized Official - Credentials:MD
Authorized Official - Phone:803-256-7530
Mailing Address - Street 1:109 BARTON CREEK CT
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:SC
Mailing Address - Zip Code:29229-8027
Mailing Address - Country:US
Mailing Address - Phone:803-256-7530
Mailing Address - Fax:803-419-8430
Practice Address - Street 1:109 BARTON CREEK CT
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29229-8027
Practice Address - Country:US
Practice Address - Phone:803-256-7530
Practice Address - Fax:803-419-8430
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-02-10
Last Update Date:2012-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC13700207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty