Individual
DR. MARTIN ERVIN CLEVELAND
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHD
Contact information
Practice address
BLANCHFIELD ARMY COMMUNITY HOSPITAL, 650 JOEL DRIVE, BLDG E, FORT CAMPBELL, KY 42223-5349
(270) 798-4097
Mailing address
5980 DESERT STORM AVE RM 33, FORT CAMPBELL, KY 42223-5514
(270) 461-1563
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
P 1078
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
36822411
—
TN
01
—
4141240
BCBS OF TN
TN
Enumeration date
09/22/2006
Last updated
01/15/2025
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