Organization
MARTIN ANESTHESIA GROUP INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PAULETTE SMITH MOREL (OFFICE MANAGER)
(731) 588-0001
Entity
Organization
Contact information
Practice address
204 POPLAR ST, MARTIN, TN 38237-3121
(731) 588-0001
(731) 587-2775
Mailing address
204 POPLAR ST, MARTIN, TN 38237-3121
(731) 588-0001
(731) 587-2775
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3631632
—
TN
Enumeration date
12/06/2006
Last updated
10/20/2011
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