MEDICARE: MARTIN CLINIC CORP

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy	License Number State
1	207R00000X	Internal Medicine Physician
2	207RC0000X	Cardiovascular Disease Physician
3	207V00000X	Obstetrics & Gynecology Physician
4	208800000X	Urology Physician
5	207LP2900X	Pain Medicine (Anesthesiology) Physician
6	208000000X	Pediatrics Physician
7	208600000X	Surgery Physician
8	207Q00000X	Family Medicine Physician	TN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	4049793	OTHER	TN	BCBS

General Provider Information

NPI Number	:	1568465102
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MARTIN CLINIC CORP

Provider Business Mailing Address
First Line	:	PO BOX 689022
Second Line	:
City	:	FRANKLIN
State	:	TN
Zip	:	37068-9022
Country	:	US
Telephone Number	:	615-778-8536
Fax Number	:	615-628-6877

Provider Business Practice Location Address
First Line	:	143 KENNEDY DR
Second Line	:	SUITE A
City	:	MARTIN
State	:	TN
Zip	:	38237-3309
Country	:	US
Telephone Number	:	731-587-5321
Fax Number	:	731-588-3229

Authorized Official
Title or Position	:	DIRECTOR/AUTHORIZED OFFICIAL
Name	:	MICHAEL A SWAW
Credential	:
Telephone Number	:	615-778-8076

Provider Enumeration Date	:	05/27/2005
Last Update Date	:	07/25/2016

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Directions to “MARTIN CLINIC CORP ” Practice Location

Language	Start Address	Practice Location

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