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1770014748
GERALD S MARTIN
CARBONDALE, IL
NPI
1770014748
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
363LF0000X Nurse Practitioner, Family
(Licence: IL 209015754)
Enumeration Date
2017-03-22
Last Update Date
2022-09-26
Business Address
GERALD S MARTIN NP
404 S LEWIS LN
CARBONDALE, IL 62901-3547
Phone number: 618-519-9200
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Mailing Address
GERALD S MARTIN NP
109 CALIFORNIA ST PO BOX 577
CARTERVILLE, IL 62918
Phone number: 618-519-9200
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