| Alfonso J Martinez Md Llc | |
|
19600 E 39th St S Independence MO 64057-2301 | |
| (816) 425-6084 | |
| (816) 873-1121 |
| Full Name | Alfonso J Martinez Md Llc |
|---|---|
| Speciality | Internal Medicine |
| Location | 19600 E 39th St S, Independence, Missouri |
| Authorized Official Name and Position | Alfonso Martinez (OWNER) |
| Authorized Official Contact | 8163099538 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Alfonso J Martinez Md Llc Po Box 1189 Independence MO 64051-0689 Ph: () - | Alfonso J Martinez Md Llc 19600 E 39th St S Independence MO 64057-2301 Ph: (816) 425-6084 |
| NPI Number | 1275098972 |
|---|---|
| Provider Enumeration Date | 02/06/2019 |
| Last Update Date | 02/06/2019 |
| Medicare PECOS PAC ID | 6608116439 |
|---|---|
| Medicare Enrollment ID | O20190314000697 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1275098972 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| Provider Name | Alfonso J Martinez |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1821013517 PECOS PAC ID: 7315080017 Enrollment ID: I20100305000643 |
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