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Todd C Martin

Hospitalist

Allopathic & Osteopathic Physicians

450 Northside Cherokee Blvd, Canton, GA 30115-8015

PECOS Enrollment

This provider is enrolled in PECOS as TODD MARTIN.

Based on the most recent information from CMS, provider Todd C Martin is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.

Part B
Medicare Part B
Enrolled
HHA
Home Health Agency
Enrolled
DME
Durable Medical Equipment
Enrolled
PMD
Power Mobility Device
Enrolled

CMS last updated its PECOS records today at 9:43 AM.

Profile Details

Provider ID
1639464936
Provider Type
Individual
Full Name
Martin, Todd C
Credential
M.D.

Gender
Male
Sole Proprietor
No
Enumeration Date
6/14/2011
Last Updated
3/7/2018

Contact Information

Practice Location

450 Northside Cherokee Blvd, Canton, GA 30115-8015

(770) 224-1000

(770) 224-2451

Mailing Location

201 Hospital Rd, Canton, GA 30114-2408

(770) 720-5100

(404) 851-6325

Provider Taxonomies

Code	Description	License
Code 208M00000X Primary	Description Hospitalist Allopathic & Osteopathic Physicians	License 067824 Georgia
Code 207R00000X	Description Internal Medicine Allopathic & Osteopathic Physicians	License N9599 Texas

Provider Identifiers

ID	Description	Issuer
ID 003126334A	Description Medicaid	Issuer Unlisted Georgia

Todd C Martin

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Provider Taxonomies

Code

Description

License

Code

Description

License

Code

Description

License

Provider Identifiers

ID

Description

Issuer

ID

Description

Issuer

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