Organization
MARVIN ASBURY BLANTON III MD PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GLORIA FAYE ISBELL (OFFICE MANAGER)
(731) 885-6662
Entity
Organization
Contact information
Practice address
1720 EAST REELFOOT AVE, SUITE 104, UNION CITY, TN 38261-6004
(731) 885-6662
(731) 885-6643
Mailing address
2379 WALKER TANNER RD, UNION CITY, TN 38261-8209
(731) 885-6662
(731) 885-6643
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
MD00005749
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3724967
—
TN
Enumeration date
02/05/2007
Last updated
06/25/2008
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