Individual
EDWIN W MARTIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
15427 S FIRST ST, MILAN, TN 38358-6475
(731) 686-3350
(731) 686-3550
Mailing address
15427 S FIRST ST, MILAN, TN 38358-6475
(731) 686-3350
(731) 686-3550
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
2189
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3943885
—
TN
05
—
77001527
—
KY
Enumeration date
12/13/2006
Last updated
08/03/2009
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