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General NPI Number Information
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NPI Number | 1730142795
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Entity Type | Organization
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Legal Business Name | CARDIOVASCULAR SPECIALIST , P.C.
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Dates
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Enumeration Date | 04/10/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 1211 UNION AVE
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City | MEMPHIS
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State | TN
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Zip | 38104-6643
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Country | US
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Telephone | 901-722-0340
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Fax |
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Provider Business Mailing Address
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Address Line | MSC 410702 P O BOX 415000
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City | NASHVILLE
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State | TN
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Zip | 37241-0001
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Country | US
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Telephone | 901-722-0340
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MR. FRANK MARTIN
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Credential | MD
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Telephone | 901-722-0340
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2086S0129X
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Taxonomy Name | Vascular Surgery Physician
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License Number | D32091
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License Number State | TN
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