Provider Demographics
NPI:1497592661
Name:MARTIN FAMILY MEDICAL LLC
Entity type:Organization
Organization Name:MARTIN FAMILY MEDICAL LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:CATHERINE
Authorized Official - Middle Name:STROUD
Authorized Official - Last Name:MARTIN
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:423-215-3753
Mailing Address - Street 1:PO BOX 5755
Mailing Address - Street 2:
Mailing Address - City:ONEIDA
Mailing Address - State:TN
Mailing Address - Zip Code:37841-1355
Mailing Address - Country:US
Mailing Address - Phone:423-215-3753
Mailing Address - Fax:
Practice Address - Street 1:19806 ALBERTA ST
Practice Address - Street 2:
Practice Address - City:ONEIDA
Practice Address - State:TN
Practice Address - Zip Code:37841-3307
Practice Address - Country:US
Practice Address - Phone:423-223-4889
Practice Address - Fax:423-214-1004
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-07-13
Last Update Date:2024-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care