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Organization

ADVANTAGE FAMILY HEALTHCARE, PLLC

Active
Other names
Campbell Station Primary Care Assoc
Organization subpart
No

Provider details

NPI number
Authorized official
MR. ROBERT MICHAEL MARTIN MS, CFNP (CHIEF MANAGER / PROVIDER)
(865) 675-7522
Entity
Organization

Contact information

Practice address
11541 KINGSTON PIKE, STE 101, KNOXVILLE, TN 37934-3918
(865) 675-7522
(865) 671-3196
Mailing address
11541 KINGSTON PIKE, STE 101, KNOXVILLE, TN 37934-3918
(865) 675-7522
(865) 671-3196

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
APN7953
TN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1659403590
GROUP NPI
01
1922004159
INDIVIDUAL NPI
05
3908484
TN
01
44D0993636
CLIA ID NUMBER
Enumeration date
06/19/2005
Last updated
05/03/2011
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