Organization
MARTIN MEDICAL CENTER, P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. TAMMY M HAZLEWOOD (ADMINISTRATOR)
(731) 587-9511
Entity
Organization
Contact information
Practice address
117 KENNEDY DR, MARTIN, TN 38237-3309
(731) 587-9511
(877) 309-6416
Mailing address
117 KENNEDY DR, MARTIN, TN 38237-3309
(731) 587-9511
(877) 309-6416
Taxonomy
Speciality
Code
Description
License number
State
261QM1300X
Multi-Specialty Clinic/Center
—
—
261QR1300X
Rural Health Clinic/Center
Primary
—
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2006779
BLUE CROSS BLUE SHIELD
TN
05
—
3371015
—
TN
Enumeration date
05/19/2006
Last updated
02/26/2024
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