Provider Demographics
NPI:1699295188
Name:MARTINEZ, JAKE CORDELL (DO)
Entity type:Individual
Prefix:
First Name:JAKE
Middle Name:CORDELL
Last Name:MARTINEZ
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1520 S DOBSON RD STE 203
Mailing Address - Street 2:
Mailing Address - City:MESA
Mailing Address - State:AZ
Mailing Address - Zip Code:85202-4726
Mailing Address - Country:US
Mailing Address - Phone:807-337-5354
Mailing Address - Fax:480-896-3374
Practice Address - Street 1:1520 S DOBSON RD STE 203
Practice Address - Street 2:
Practice Address - City:MESA
Practice Address - State:AZ
Practice Address - Zip Code:85202-4726
Practice Address - Country:US
Practice Address - Phone:807-337-5354
Practice Address - Fax:480-896-3374
Is Sole Proprietor?:No
Enumeration Date:2017-06-26
Last Update Date:2025-08-26
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
AZ12038207RC0001X
AZ009122207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0001XAllopathic & Osteopathic PhysiciansInternal MedicineClinical Cardiac Electrophysiology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine