# BANE MEDICAL MANAGEMENT LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** ABC Medical
- **Organization subpart:** No

## Provider details

- **NPI number:** 1962103960
- **Authorized official:** MATTHEW BANE (OWNER)
- **Authorized official phone:** (845) 820-0057

## Contact information

- **Practice address:** 415 S LINDELL ST, MARTIN, TN 38237-2442
- **Practice address phone:** (731) 255-5138
- **Mailing address:** 118 HIDDEN HILL CV, MARTIN, TN 38237-1000
- **Mailing address phone:** (845) 820-0057

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | Yes |
| 207Q00000X | Family Medicine Physician | — | — | Yes |

## Other

- **Enumeration date:** 03/15/2023
- **Last updated:** 03/27/2023