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General NPI Number Information
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NPI Number | 1841411642
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Entity Type | Organization
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Legal Business Name | MARTIN CLINIC CORP
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Dates
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Enumeration Date | 05/01/2007
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Last Update Date | 02/27/2008
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Provider Practice Location Address
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Address Line | 143 KENNEDY DR SUITE A
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City | MARTIN
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State | TN
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Zip | 38237-3309
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Country | US
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Telephone | 731-587-5321
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Fax | 731-587-2145
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Provider Business Mailing Address
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Address Line | 7100 COMMERCE WAY SUITE 180
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City | BRENTWOOD
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State | TN
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Zip | 37027-2829
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Country | US
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Telephone | 615-465-3007
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Fax |
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Authorized Official
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Title or Position | DIRECTOR
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Name | DEBBIE BREWER
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Credential |
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Telephone | 877-892-9813
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 261QR1300X
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Taxonomy Name | Rural Health Clinic/Center
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License Number |
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License Number State |
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