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Contact Information

RANDALL L MARTIN, MD
204 MCCOLLUM DRIVE
SUITE 101
LARAMIE, WY82070
 Phone: 307-745-6065
 Fax: 307-745-4936
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Anesthesiology

207L00000X 79 Physician/Addiction Medicine
Indicates primary specialty

NPI Profile & details for RANDALL L MARTIN · (Male)

NPI # 1215955885
Status Active
Credentials MD
Entity Individual
Enumeration date 07/18/2006
Last updated 05/15/2018 - About 8 years ago
Sole proprietor 1 No
Identifiers
  • OR License # MD14891
  • WA License # 60771584
  • WY License # TL1962
  • IN Medicaid 200948040
  • OR Medicaid 176917
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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