National Provider Identifier Database

MARTIN PEDIATRIC AND ADOLESCENT CLINIC PC
Adolescent Medicine

A pediatrician who specializes in adolescent medicine is a multi-disciplinary healthcare specialist trained in the unique physical, psychological and social characteristics of adolescents, their healthcare problems and needs.


Contact Information

MARTIN PEDIATRIC AND ADOLESCENT CLINIC, PC
142 MOUNT PELIA RD
MARTIN, TN38237-3812
Phone: 731-587-9542
Fax:
Website:
Specialty Taxonomy Code
* Adolescent Medicine 2080A0000X

* Indicates primary specialty

NPI Profile & details for MARTIN PEDIATRIC AND ADOLESCENT CLINIC, PC

NPI Number 1649314501
Legal business name
LBN
MARTIN PEDIATRIC AND ADOLESCENT CLINIC, PC
Authorized official BARBARA ROBERTS - (OFFICE MANAGER)
Entity Organization
Organization subpart No
Enumeration date 02/16/2007
Last updated 07/11/2007 - About 19 years ago
Sole proprietor1 Not specified
Identifiers
  • TN License #: MD 18562
  • TN Medicaid: 3727836

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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