DR. CLIFFORD GLENN MARTIN (NPI# 1457314056) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1457314056 |
| Entity Type | Individual |
| Full Name | DR. CLIFFORD GLENN MARTIN |
| Credential | M.D. |
| Practice Address |
2 Saint Anthonys Way Alton IL 62002-4569 |
| Practice Telephone | 6184622222 |
| Mailing Telephone | 6184622222 |
| Enumeration Date | 2006-04-06 |
| Last Update Date | 2016-04-29 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207V00000X | Obstetrics & Gynecology | 01072884A | IN | Allopathic & Osteopathic Physicians |
| N | 207V00000X | Obstetrics & Gynecology | 30961-020 | WI | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IN | 201311140 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619990892 | Clifford Lee Martin | Dentist | 701 N Weinbach Ave, Suite 920, Evansville, IN 47711 | 2006-07-26 |
| 1760429864 | Clifford P Martin | Internal Medicine | 5230 E Farness Dr, Suite 100, Tucson, AZ 85712-2141 | 2006-05-31 |
| Street Address |
2 SAINT ANTHONYS WAY |
| City | ALTON |
| State | IL |
| Zip Code | 62002-4569 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972585677 | Dennis E. Sands | Obstetrics & Gynecology | 2 Saint Anthonys Way, Alton, IL 62002-4569 | 2005-11-17 |
| 1023584042 | Tawny Nicole Thomas | Nurse Practitioner | 2 Saint Anthonys Way, Alton, IL 62002-4569 | 2018-10-17 |
| 1992289979 | Roxanne R Strohbeck | Nurse Practitioner | 2 Saint Anthonys Way, Alton, IL 62002-4569 | 2018-09-17 |
| 1861975849 | Colin Michael Solomon | Nurse Practitioner | 2 Saint Anthonys Way, Alton, IL 62002-4569 | 2018-09-14 |
| 1639508039 | Billie Vincent | Nurse Practitioner | 2 Saint Anthonys Way, Suite 205, Alton, IL 62002-4569 | 2013-11-06 |
| 1790065464 | Saikiran Raghavapuram | Internal Medicine | 2 Saint Anthonys Way, Alton, IL 62002-4569 | 2011-08-25 |
| 1407144231 | Kate A Smith | Physician Assistant | 2 Saint Anthonys Way, Suite 305, Alton, IL 62002-4569 | 2011-07-13 |
| 1700112521 | Lisa M Fritcher | Physician Assistant | 2 Saint Anthonys Way, Alton, IL 62002-4569 | 2009-10-29 |
| 1851524011 | Carole H Mckinstry | Nurse Practitioner | 2 Saint Anthonys Way, Suite 305, Alton, IL 62002-4569 | 2009-09-03 |
| 1902062862 | Priya Kumaraguru | Family Medicine | 2 Saint Anthonys Way, Suite 205, Alton, IL 62002-4569 | 2008-07-31 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285272807 | Jersey Community Hospital | Obstetrics & Gynecology | #2 Memorial Drive, Suite 203, Alton, IL 62002 | 2019-12-13 |
| 1912540659 | Kelsi N Harre | Community Health Worker | 2603 N. Rogers Ave., Alton, IL 62002 | 2019-10-25 |
| 1841848322 | Destiny L Miller | Technician | 3429 Meridocia St, Alton, IL 62002 | 2019-08-28 |
| 1942854633 | Jessica Leigh Jump | Speech-Language Pathologist | 453 Bluff Street, Alton, IL 62002 | 2019-07-30 |
| 1194380741 | Vasiliki Kytridou | Dentist | 2800 College Avenue Southern Il University School of De, Building 285, Alton, IL 62002 | 2019-05-08 |
| 1982125910 | Amy Nicole Spalding | Social Worker | 1123 Harrison St, Alton, IL 62002 | 2017-06-29 |
| 1962856310 | Patricia Gregory | Social Worker | 5090 Humbert Rd, Alton, IL 62002 | 2016-04-21 |
| 1447612510 | Alanna Lynn Mcnelly | Chiropractor | 219 Piasa St, Suite 200, Alton, IL 62002 | 2016-03-28 |
| 1174983050 | Roberta's Lovely Ladies Boutique | Mastectomy Fitter | 603 W. Delmar, Alton, IL 62002 | 2016-03-04 |
| 1184081556 | Darcy Graham | Nurse Practitioner | 4 Memorial Dr # 210, Alton, IL 62002 | 2016-01-15 |
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| Taxonomy Code | 207V00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Obstetrics & Gynecology |
| An obstetrician/gynecologist possesses special knowledge, skills and professional capability in the medical and surgical care of the female reproductive system and associated disorders. This physician serves as a consultant to other physicians and as a primary physician for women. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Obstetrics and Gynecology, 2007. http://www.abog.org/. American Osteopathic Board of Obstetrics and Gynecology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Obstetrics and Gynecology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Obstetrics and Gynecology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285272807 | Jersey Community Hospital | Obstetrics & Gynecology | #2 Memorial Drive, Suite 203, Alton, IL 62002 | 2019-12-13 |
| 1922403096 | Jersey Community Hospital | Obstetrics & Gynecology | 2 Memorial Dr Ste 203, Alton, IL 62002-6723 | 2014-10-30 |
| 1639518913 | Bindu N Patel | Obstetrics & Gynecology | 4 Memorial Dr Ste 125, Alton, IL 62002-6704 | 2013-06-19 |
| 1972585677 | Dennis E. Sands | Obstetrics & Gynecology | 2 Saint Anthonys Way, Alton, IL 62002-4569 | 2005-11-17 |
| 1093060584 | Jamie Hardman | Obstetrics & Gynecology | 4 Memorial Dr Ste 210, Alton, IL 62002 | 2012-07-20 |
| 1730318890 | Rachel Durham | Obstetrics & Gynecology | 1 Professional Dr, Alton, IL 62002-5068 | 2009-07-10 |
| 1336277573 | Illini Medical Associates Sc | Obstetrics & Gynecology | 2 Saint Anthonys Way, Alton, IL 62002-4569 | 2007-03-01 |
| 1942350202 | James Watson Stubbs Jr. | Obstetrics & Gynecology | 2 Memorial Dr, 122, Alton, IL 62002-6723 | 2007-01-11 |
| 1972699932 | Charles D. Herzon | Obstetrics & Gynecology | 2 Memorial Dr, Suite 122, Alton, IL 62002-6723 | 2006-10-05 |
| 1174619225 | Geoffrey L. Turner | Obstetrics & Gynecology | 4 Memorial Dr Ste 210, Alton, IL 62002 | 2006-10-05 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.