Provider Demographics
NPI:1548327737
Name:PITTMAN, MARTHA BYNUM (PHD)
Entity type:Individual
Prefix:DR
First Name:MARTHA
Middle Name:BYNUM
Last Name:PITTMAN
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:DR
Other - First Name:MARCI
Other - Middle Name:BYNUM
Other - Last Name:PITTMAN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PHD
Mailing Address - Street 1:6501 FOREST PARK DR
Mailing Address - Street 2:
Mailing Address - City:SIGNAL MOUNTAIN
Mailing Address - State:TN
Mailing Address - Zip Code:37377-2815
Mailing Address - Country:US
Mailing Address - Phone:423-596-8589
Mailing Address - Fax:
Practice Address - Street 1:6401 SHALLOWFORD RD
Practice Address - Street 2:
Practice Address - City:CHATTANOOGA
Practice Address - State:TN
Practice Address - Zip Code:37421-5406
Practice Address - Country:US
Practice Address - Phone:423-893-6500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-03
Last Update Date:2023-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN2657103TC0700X, 103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No103T00000XBehavioral Health & Social Service ProvidersPsychologist