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Contact Information

MARTIN PEDIATRIC AND ADOLESCENT CLINIC, PC
142 MOUNT PELIA RD
MARTIN, TN38237-3812
 Phone: 731-587-9542
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Adolescent Medicine

2080A0000X 37 Physician/Pediatric Medicine
Indicates primary specialty

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

NPI # 1649314501
LBN Legal business name MARTIN PEDIATRIC AND ADOLESCENT CLINIC, PC
Authorized official BARBARA ROBERTS - (OFFICE MANAGER)
Entity Organization
Organization subpart 1 No
Enumeration date 02/16/2007
Last updated 07/11/2007 - About 19 years ago
Identifiers
TN License # MD 18562
TN Medicaid 3727836
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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