Individual
DR. THOMAS F MARTIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1050 W 10TH ST, STE 500, ROLLA, MO 65401-2905
(573) 308-1301
(573) 308-1305
Mailing address
1050 W 10TH ST, ATTN: EXECUTIVE DIRECTOR PF PHYSICIAN CLINICS, ROLLA, MO 65401-2905
(573) 364-9000
(573) 426-2108
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
30043
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036046567
—
IL
05
—
916610183
—
MO
Enumeration date
08/13/2006
Last updated
08/22/2019
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