Provider Demographics
NPI:1366298713
Name:MARTIN, ROBERT LEE III (DO)
Entity type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:LEE
Last Name:MARTIN
Suffix:III
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8175 CORALBERRY LN W
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32244-6110
Mailing Address - Country:US
Mailing Address - Phone:334-763-0357
Mailing Address - Fax:
Practice Address - Street 1:1303 WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:MARION
Practice Address - State:AL
Practice Address - Zip Code:36756-3217
Practice Address - Country:US
Practice Address - Phone:205-920-2998
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-04-26
Last Update Date:2024-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program