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Jacob Anthony Martin

Anesthesiology

Allopathic & Osteopathic Physicians

111 Colchester Ave, Anesthesiology, Wp 2, Burlington, VT 05401-1473

PECOS Enrollment

This provider is enrolled in PECOS as JACOB MARTIN.

Based on the most recent information from CMS, provider Jacob Anthony 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 5 days ago.

Profile Details

Provider ID
1841344959
Provider Type
Individual
Full Name
Martin, Jacob Anthony
Title
Dr.
Credential
M.D.

Gender
Male
Sole Proprietor
Yes
Enumeration Date
1/23/2007
Last Updated
7/23/2008

Contact Information

Practice Location

111 Colchester Ave, Anesthesiology, Wp 2, Burlington, VT 05401-1473

(802) 847-0231

Unlisted Fax

Mailing Location

17 Seneca Ave, Essex Junction, VT 05452-3521

(802) 878-6619

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 207L00000X Primary	Description Anesthesiology Allopathic & Osteopathic Physicians	License 0420011593 Vermont

Jacob Anthony Martin

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Provider Taxonomies

Code

Description

License

Code

Description

License

Heller, Alex

Fitzgerald, Joseph R

Harmeyer, Don

Aslakson, Rebecca Ann

Stebbins, Emily L. A.

Kent, Eric L.

Meehan, Barry

Litsakos, Christina Marie

Abnet, Kevin Richard

Hamlin, Mark P