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Contact Information

TRACY B MARTIN, PA
2610 TRINITY DR STE 14
LOS ALAMOS, NM87544-2362
 Phone: 505-500-8213
 Fax: 505-451-0580
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Physician Assistant

363A00000X 97 Physician Assistant
 

Adult Medicine

207QA0505X 08 Physician/Family Practice
Indicates primary specialty

NPI Profile & details for TRACY B MARTIN · (Female)

NPI Number 1952460057
Status Active
Credentials PA (Physician Assistant)
Entity Individual
Enumeration date 12/06/2006
Last updated 10/11/2022 - About 4 years ago
Sole proprietor 1 No
Identifiers
  • NM License # 99-PA28
  • NM License # 99PA28
  • NM Medicaid 000N1651
  • Other 10029201 LOVELACE
  • Other QMP000003399104 MOLINA
Hospital affiliation(s)
  • LOS ALAMOS MEDICAL CENTER - (Acute Care)
    3917 WEST ROAD
    LOS ALAMOS, NM 87544
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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