Individual
PHILLIP A MARTIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
1 MEDICAL PARK BLVD, BRISTOL, TN 37620-7430
(423) 844-2686
(423) 844-2688
Mailing address
297 DAVIS RD, SHADY VALLEY, TN 37688-5090
(423) 844-2686
(423) 844-2688
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
84226
VA
Other
Enumeration date
01/28/2010
Last updated
04/22/2014
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