Individual
JUSTIN LEE MARLAR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
294 SUMMAR DR, JACKSON, TN 38301-3915
(731) 423-1932
(731) 410-0367
Mailing address
294 SUMMAR DR, JACKSON, TN 38301-3915
(731) 423-1932
(731) 410-0367
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
49097
TN
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/29/2011
Last updated
06/23/2014
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