Individual
DR. TOM PEARCE MARTIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
10900 PORTER LN, JUNCTION, IL 62954-2200
(618) 269-4034
Mailing address
10900 PORTER LN, JUNCTION, IL 62954-2200
Taxonomy
Speciality
Code
Description
License number
State
261QE0002X
Emergency Care Clinic/Center
Primary
036-049331
IL
Other
Enumeration date
06/24/2008
Last updated
06/24/2008
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