MEDICARE: MR. MARTIN J FIALA MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207X00000X	Orthopaedic Surgery Physician	MD26680	TN
2	208100000X	Physical Medicine & Rehabilitation Physician	MD26680	TN
3	2086S0105X	Surgery of the Hand (Surgery) Physician	MD26680	TN

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
4	200034386	OTHER		RAILROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	0940299	OTHER		UNITED HEALTH CARE
2	3093522	OTHER	TN	BLUE CROSS
3	682362	OTHER		AETNA
5	621738887002	OTHER		PRUDENTIAL
6	TN0102	OTHER	TN	AMERICHOICE
7	10070490	OTHER	TN	AMERIGROUP
8	1536928	OTHER		UMWA
9	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
10	5541521	OTHER		CIGNA

General Provider Information

NPI Number	:	1619961976
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. MARTIN J FIALA MD

Provider Business Mailing Address
First Line	:	1816 N WASHINGTON ST
Second Line	:	SUITE 100
City	:	TULLAHOMA
State	:	TN
Zip	:	37388-2222
Country	:	US
Telephone Number	:	931-455-8676
Fax Number	:	931-455-9983

Provider Business Practice Location Address
First Line	:	1816 N WASHINGTON ST
Second Line	:	SUITE 100
City	:	TULLAHOMA
State	:	TN
Zip	:	37388-2222
Country	:	US
Telephone Number	:	931-455-8676
Fax Number	:	931-455-9983

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/01/2005
Last Update Date	:	04/07/2011

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Directions to “ MR. MARTIN J FIALA MD” Practice Location

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