Individual
LISA K MARTIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OD
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
ODT 2188
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3944289
—
TN
01
—
4041310
BCBS
TN
01
—
810552726
CIGNA, UHC
TN
Enumeration date
07/11/2006
Last updated
07/13/2023
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