person
Gerald S Martin, NP
Family Nurse Practitioner in Carbondale, Illinois
NPI 1770014748

Gerald S Martin is a Family Nurse Practitioner based in Carterville, IL and is specialized in Family. Gerald S Martin practices in Carbondale, IL and has the professional credentials of NP. The NPI Number for Gerald S Martin is 1770014748 and holds a License No. 209015754 (Illinois).

The current practice location address for Gerald S Martin is 404 S Lewis Ln, Carbondale, IL and can be reached out via phone at 618-519-9200 and via fax at 618-549-1288.

Location: 404 S Lewis Ln, Carbondale, IL, 62918
person
Provider Profile Details
NPI Number
1770014748
Provider Name
Gerald S Martin
Credential
NP
Provider Entity Type
Individual
Gender
Male
Address
404 S Lewis Ln, Carbondale, IL, 62918
Phone Number
618-519-9200
Fax Number
618-549-1288
Provider Enumeration Date
03/22/2017
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
214881 01 IL MEDICARE GROUP PTAN
institution
Provider Business Practice Location Address Details
Address
404 S Lewis Ln
City
State
Zip
62901-3547
Phone Number
618-519-9200
Fax Number
618-549-1288
person
Provider Business Mailing Address Details
Address
404 S Lewis Ln
City
State
Zip
62901-3547
Phone Number
618-519-9200
Fax Number
618-549-1288
person
Provider's Taxonomy Details 1
Type
Physician Assistants & Advanced Practice Nursing Providers
Classification
Nurse Practitioner
Speciality
Family
Taxonomy
License No.
209015754 (Illinois)
Definition
Definition to come...
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