Active NPI
Robert William Martin III, MD
- Dermatology Physician
- Evansville, IN
National Provider Identifier
1215906516
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dermatology Physician
- License
- 01044875A
- Practice address
- 421 Chestnut St
Evansville, IN 47713-1227 - Phone
- (812) 426-9355
- Fax
- (812) 858-4539
- NPI assigned
- Mar 17, 2006
- Last updated
- Sep 10, 2014
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dermatology Physician | 207N00000X | 01044875A | IN | Primary |
Addresses
Primary practice location
421 Chestnut St
Evansville, IN 47713-1227
Mailing address
PO Box 3868
Evansville, IN 47737-3868
Phone (812) 426-9355
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 01044875A | IN | MD | Dermatology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1142553600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1410307200000",
"number": "1215906516",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 3868",
"city": "EVANSVILLE",
"state": "IN",
"postal_code": "477373868",
"telephone_number": "812-426-9355",
"fax_number": "812-858-4539"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "421 CHESTNUT ST",
"city": "EVANSVILLE",
"state": "IN",
"postal_code": "477131227",
"telephone_number": "812-426-9355",
"fax_number": "812-858-4539"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MARTIN",
"first_name": "ROBERT",
"middle_name": "WILLIAM",
"name_suffix": "III",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-03-17",
"last_updated": "2014-09-10",
"status": "A"
},
"taxonomies": [
{
"code": "207N00000X",
"taxonomy_group": "",
"desc": "Dermatology",
"state": "IN",
"license": "01044875A",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Evansville, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.