Provider Demographics
NPI:1902809718
Name:MARTIN, DAVID CHRISTOPHER (DO)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:CHRISTOPHER
Last Name:MARTIN
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 700
Mailing Address - Street 2:
Mailing Address - City:SEWANEE
Mailing Address - State:TN
Mailing Address - Zip Code:37375-0700
Mailing Address - Country:US
Mailing Address - Phone:931-598-5648
Mailing Address - Fax:931-598-0778
Practice Address - Street 1:205 HOSPITAL DR STE A
Practice Address - Street 2:
Practice Address - City:MC KENZIE
Practice Address - State:TN
Practice Address - Zip Code:38201-1649
Practice Address - Country:US
Practice Address - Phone:731-352-7907
Practice Address - Fax:731-352-4459
Is Sole Proprietor?:No
Enumeration Date:2005-05-24
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNDO1376207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN1477516953OtherGROUP NPI
TN3306765Medicaid
TN1063817625OtherGROUP NPI
TNDO1376OtherMEDICAL LICENSE
TNBM7115149OtherDEA LICENSE
TN1063817625OtherGROUP NPI