Active NPI
William C Martin, MD
- Gastroenterology Physician
- Fayetteville, AR
National Provider Identifier
1609811603
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Gastroenterology Physician
- License
- C-4338
- Practice address
- 3344 N Futrall Dr
Fayetteville, AR 72703-4057 - Phone
- (479) 521-8200
- Fax
- (479) 582-7310
- NPI assigned
- Jun 17, 2006
- Last updated
- Feb 27, 2008
- 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 |
|---|---|---|---|---|
| Gastroenterology Physician | 207RG0100X | C-4338 | AR | Primary |
Addresses
Primary practice location
3344 N Futrall Dr
Fayetteville, AR 72703-4057
Mailing address
PO Box 1523
Fayetteville, AR 72702-1523
Phone (479) 521-8200
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 53326 | Other | AR | AR BC/BS |
| P00224223 | Other | AR | RR MCR |
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 |
|---|---|---|---|
| C-4338 | AR | MD | Gastroenterology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1150502400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1204070400000",
"number": "1609811603",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 1523",
"city": "FAYETTEVILLE",
"state": "AR",
"postal_code": "727021523",
"telephone_number": "479-521-8200",
"fax_number": "479-582-7310"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3344 N FUTRALL DR",
"city": "FAYETTEVILLE",
"state": "AR",
"postal_code": "727034057",
"telephone_number": "479-521-8200",
"fax_number": "479-582-7310"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MARTIN",
"first_name": "WILLIAM",
"middle_name": "C",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-06-17",
"last_updated": "2008-02-27",
"status": "A"
},
"taxonomies": [
{
"code": "207RG0100X",
"taxonomy_group": "",
"desc": "Internal Medicine, Gastroenterology",
"state": "AR",
"license": "C-4338",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AR BC/BS",
"identifier": "53326",
"state": "AR"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RR MCR",
"identifier": "P00224223",
"state": "AR"
}
],
"endpoints": [],
"other_names": []
}Other providers in Fayetteville, AR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 27, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.