# MARTIN CHILDREN'S CLINIC, LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1194049064
- **Authorized official:** MRS. SHARON PIERCE PAGE APN (OWNER)
- **Authorized official phone:** (731) 587-5138

## Contact information

- **Practice address:** 130 COMMONS DR, MARTIN, TN 38237-3879
- **Practice address phone:** (731) 587-5138
- **Practice address fax:** (731) 587-0552
- **Mailing address:** 130 COMMONS DR, MARTIN, TN 38237-3879
- **Mailing address phone:** (731) 587-5138
- **Mailing address fax:** (731) 587-0552

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QR1300X | Rural Health Clinic/Center | 12549 | TN | Yes |
| 363LP0200X | Pediatric Nurse Practitioner | 12549 | TN | — |

## Other

- **Enumeration date:** 03/22/2010
- **Last updated:** 05/09/2017