Provider Demographics
NPI:1548281975
Name:MARTIN, JENNIFER A (MD)
Entity type:Individual
Prefix:DR
First Name:JENNIFER
Middle Name:A
Last Name:MARTIN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2609 NEW HARTFORD RD STE 1
Mailing Address - Street 2:
Mailing Address - City:OWENSBORO
Mailing Address - State:KY
Mailing Address - Zip Code:42303-1316
Mailing Address - Country:US
Mailing Address - Phone:270-683-3073
Mailing Address - Fax:270-852-1610
Practice Address - Street 1:1003 BURLEW BLVD STE C
Practice Address - Street 2:
Practice Address - City:OWENSBORO
Practice Address - State:KY
Practice Address - Zip Code:42303-1799
Practice Address - Country:US
Practice Address - Phone:270-683-3073
Practice Address - Fax:270-852-1610
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-21
Last Update Date:2024-05-21
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
KY40335207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine