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General NPI Number Information
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NPI Number | 1326088634
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Entity Type | Individual
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Provider Name | THOMAS MARTIN RN, CRNA
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Gender | Male
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Dates
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Enumeration Date | 06/07/2006
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Last Update Date | 02/04/2016
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Provider Practice Location Address
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Address Line | 2000 JOSEPH E. SANKER BOULEVARD
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City | CINCINNATI
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State | OH
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Zip | 45212
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Country | US
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Telephone | 513-204-5696
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Fax | 877-284-4283
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Provider Business Mailing Address
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Address Line | 4549 RAYNOR COURT
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City | MASON
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State | OH
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Zip | 45040
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Country | US
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Telephone | 513-204-5696
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Fax | 877-284-4283
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 117984
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | NA029000
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License Number State | OH
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Taxonomy #3
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Taxonomy Code | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number | 029000
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License Number State | OH
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