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MR. CLINTON RICHARD MARTIN P.A.

>> Physician Assistant >> Physician Assistants & Advanced Practice Nursing Providers

Registrant NPI Number: 1013228394

Individual Registrant:
MR. CLINTON RICHARD MARTIN P.A.
Gender: M
Not Sole Proprietor

Location and contact information for practice:
3650 S POINTE CIR STE 106  LAUGHLIN, NV 89029-0422 US
Tel: 702-254-1425  Fax: 702-243-5012

Contact information for business:
9101 W SAHARA AVE # 105-51  LAS VEGAS, NV 89117-5772 US
Tel: 702-254-1425  Fax: 702-243-5012

Registration Information:
NPI: 1013228394
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
N363A00000XPhysician Assistants & Advanced Practice Nursing Providers
Physician Assistant
AZ5486
N363A00000XPhysician Assistants & Advanced Practice Nursing Providers
Physician Assistant
NVPA1351
N363A00000XPhysician Assistants & Advanced Practice Nursing Providers
Physician Assistant
NVPA0270
Y363A00000XPhysician Assistants & Advanced Practice Nursing Providers
Physician Assistant
TXPA12064

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType
1013228394NV05
1366544124NV05




HEALTH CARE JOBS NV - Page 1



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