Individual
MARTY MARIA ALEXANDER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
150 GUINN ST, SAVANNAH, TN 38372-2026
(731) 925-2300
Mailing address
P O BOX 655, SAVANNAH, TN 38372-0655
(731) 925-2300
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
1609
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1507608
—
TN
01
—
4207826
BCBS
TN
Enumeration date
07/09/2008
Last updated
05/11/2010
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