Provider Demographics
NPI:1174741573
Name:MARTIN FOOT SPECIALISTS, INC
Entity type:Organization
Organization Name:MARTIN FOOT SPECIALISTS, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:KENT
Authorized Official - Middle Name:S
Authorized Official - Last Name:MARTIN
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:256-389-1990
Mailing Address - Street 1:426 COX BLVD
Mailing Address - Street 2:
Mailing Address - City:SHEFFIELD
Mailing Address - State:AL
Mailing Address - Zip Code:35660-4000
Mailing Address - Country:US
Mailing Address - Phone:256-389-1990
Mailing Address - Fax:
Practice Address - Street 1:426 COX BLVD
Practice Address - Street 2:
Practice Address - City:SHEFFIELD
Practice Address - State:AL
Practice Address - Zip Code:35660-4000
Practice Address - Country:US
Practice Address - Phone:256-389-1990
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-23
Last Update Date:2008-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL169213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL51078987OtherBLUE CROSS & BLUE SHIELD
AL51078987OtherBLUE CROSS & BLUE SHIELD
ALU16617Medicare UPIN