Provider Demographics
NPI:1053574699
Name:MARTIN, JAMES CAREY III (RPH)
Entity type:Individual
Prefix:
First Name:JAMES
Middle Name:CAREY
Last Name:MARTIN
Suffix:III
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3487 US HIGHWAY 84
Mailing Address - Street 2:
Mailing Address - City:BLACKSHEAR
Mailing Address - State:GA
Mailing Address - Zip Code:31516-2293
Mailing Address - Country:US
Mailing Address - Phone:912-449-6616
Mailing Address - Fax:912-449-5759
Practice Address - Street 1:3487 US HIGHWAY 84
Practice Address - Street 2:
Practice Address - City:BLACKSHEAR
Practice Address - State:GA
Practice Address - Zip Code:31516-2293
Practice Address - Country:US
Practice Address - Phone:912-449-6616
Practice Address - Fax:912-449-5759
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-03
Last Update Date:2022-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA017263183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist