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Individual

PATTY M MARVEL

Active
Sole proprietor

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
1821 N WASHINGTON ST, TULLAHOMA, TN 37388-2221
(931) 455-2005
(931) 455-4450
Mailing address
1821 N WASHINGTON ST, TULLAHOMA, TN 37388-2221
(931) 455-2005
(931) 455-4450

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
29709
TN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
3088856
BLUE CROSS BLUE SHIELD
TN
05
3820951
TN
Enumeration date
06/14/2005
Last updated
07/08/2007
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