Provider Demographics
NPI:1174575575
Name:MARTIN, SCOTT A (DC)
Entity type:Individual
Prefix:DR
First Name:SCOTT
Middle Name:A
Last Name:MARTIN
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1420 DELLWOOD RD
Mailing Address - Street 2:
Mailing Address - City:WAYNESVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28786-6914
Mailing Address - Country:US
Mailing Address - Phone:828-944-0186
Mailing Address - Fax:828-944-0183
Practice Address - Street 1:1420 DELLWOOD RD
Practice Address - Street 2:
Practice Address - City:WAYNESVILLE
Practice Address - State:NC
Practice Address - Zip Code:28786-6914
Practice Address - Country:US
Practice Address - Phone:828-944-0186
Practice Address - Fax:828-944-0183
Is Sole Proprietor?:No
Enumeration Date:2006-05-16
Last Update Date:2010-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC1795111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC08617OtherBLUE CROSS BLUE SHEILD
NC350055782OtherRAILROAD MEDICARE
NC2446602BMedicare ID - Type Unspecified
NCU02630Medicare UPIN